Christopher Pencak,
Attorney and Pharmacist
27322 - 23 Mile Road,
Suite 7 ▪ Chesterfield, MI 48051 ▪ 586-598-4650
Website: pharmacylawpro.com ▪ Email: cpencak@pharmacylawpro.com
Permanent
Loss of Pharmacist Jobs in Michigan?
Telepharmacy
would allow one pharmacist through the use of computer technology such as Skype
to oversee other pharmacies and even the dispensing of meds through machines
such as PYXIS. If you are a Michigan
pharmacist or a pharmacy student, you should do everything in your power to
prevent the passage of this bill or any similar law.
*Read the rest
of the important details in my Blog. Also,
see my Blog on Joblessness Crisis for New Pharmacy Grads.
Contrast
Being a Pharmacist in California versus the New Michigan
As
a pharmacist would you rather fill medicine in empty slots of a drug vending
machine or be a well-paid, significant contributor to clinical medical therapy
and be able to prescribe medicines? California government is controlled by the
Democratic Party and its pharmacist associations are progressive and powerful.
California Pharmacists obtained their
primary goals of fee for service billing for clinical services such as MTM and
CDTM and expanded the scope of
practice for California pharmacists!
For more than a year a coalition that
includes the California Society of Health-System Pharmacists and the California
Pharmacists Association has been working on SB 493. The primary goals were to facilitate fee-for-service
billing clinical services, e.g., MTM and CDTM, and prescribe a variety of drugs
directly to patients.
SB 493 will become law on 1/1/2014, but
some provisions will take months to implement.
All California pharmacists will be able to “provide” immunizations for
patients over age three, and “furnish” prescription travel medication, hormonal
contraceptives, and smoking cessation therapy, after some compliance with
certain protocols.
Additionally, the Bill creates the
official category of “Advanced Practice Pharmacist” (APP). It retained
the State’s current CDTM provisions but provides another way to gain even more
authority and state recognition of advanced status. Recognition will be in accordance with
regulations to be developed by the Pharmacy Board. Recognition of APPs will
help implement the Provider Status goals and elevate the role of pharmacists as
part of team healthcare in ACO’s and other health systems.
California’s SB 493 is an outstanding
example of highly effective pharmacy organizations and a majority of State
lawmakers and governor who look out for the well-being of all of its citizens
of California and not just the elites.
Meanwhile in Michigan our wingnuts are
saying pharmacists are overpaid, superfluous clerks, that patients only need
their prescribers and a vending machine.
Exhilarating
Balance in life is important. I need new goals to achieve. I never knew this sport existed until this
summer when I saw a documentary and YouTube videos of people riding mountain
bikes downhill at Whistler Mountain in British Columbia (YouTube search
Whistler BC MTB downhill). I only knew of adults bicycling on roads for tedious
miles for exercise or because they lost their driver’s license. Downhilling is
far from boring. These riders take specialized bikes on chairlifts or gondolas
to the top of a mountain and ride them downhill over courses that include the
natural terrain, speed, as well as man-made jumps and obstacles. I watched YouTube
videos from a first person perspective as people put GoPro cameras on their
helmets and skillfully raced down famous trails at Whistler—some not so
skillfully.
I bought a helmet and went to Boyne
Highlands, Michigan, rented a downhill bike and took a chairlift to the top and
rode downhill at crazy speeds. In short, it was so frightening that when I got
to the bottom, I immediately got back on the chairlift and did it for the next
three hours.
There was the call of Whistler, BC,
arguably the best downhill mountain biking and freeriding in the world. But
could I go? Should I go? I went. At the
end of September, I took a short family vacation and stayed at Whistler
Village, the site of the 2010 Winter Olympics, and I rode downhill for three
days with my youngest son, Brent.
By now I had acquired a lot of information
and some skills since Boyne Mountain and we both had full-face helmets, goggles
and the other available body armor. You can rent everything you need at
Whistler. I came to Whistler late in the season and there was already snow at
the top of the mountains. And then there was rain every day but the first.
Interestingly, riders frequently encounter black bear on the mountain. Downhilling is one of those sports where you
are in the present. I guess that’s a part of why I like it, you cannot think
about the past or future but you must pay full attention to the moment.
Is it safe? You can be severely injured or
even killed, but I think that cycling on roads and being hit by a car carries
the same sort of risks but without the thrills and skills of downhilling.
Whistler is a magical place in every way
and if you go I suggest that you get in the best possible physical condition,
particularly with dead lifts and one-legged squats (“pistols”). In short, you
need courage, technique, balance, strength, and a good sense of judgment. Biking
season is over in the North Country but I will be training during the cold,
dark Michigan nights to be ready for spring.
Freedom and Dignity
I continue to be astonished at how frequently
hospitals and other corporate employers get their highly educated, respected
health professional employees to submit to being confined in a room, hostilely
interrogated, their body and personal effects searched and driven to
laboratories to give witnessed urine
and hair samples to be screened for drugs. All of the above and more are
conducted in the absence of legal counsel and the employees go along with it.
Even the FBI can’t do the above to
you under the same circumstances. Absent your consent or a search warrant, the
above is false imprisonment, assault & battery and arguably criminal sexual
conduct. At the least, this is an extremely humiliating way to treat a health
professional.
Health professionals have given up their
constitutional rights, dignity and self-respect because they are at-will
employees and fear job loss. Employees are subjected to all of the above
sometimes merely because an employee’s eyes appear reddened, they seem sleepy,
or a supervisor doesn’t like them.
An employee is taken into a room with
security guards and questioned in a hostile fashion and the employee, in an
emotional state, cooperates and answers questions without a lawyer. Quite often
the questions involve clearly illegal subjects of inquiry including the patient’s
private medical history and treatment, psychological history, religion and
ethnic customs and private life. Their facebook pages are scrutinized. Fellow
employees are encouraged to inform on each other. Lives are ruined. And this is
normal?
In
an employment situation, a health professional is exchanging her time and
skills to an employer in return for a paycheck. When did the American public
decide to give police powers to private corporations? In most of these
instances the at-will employee (whether they are right or wrong) is terminated
and they leave with reports to State licensing boards that they were terminated
or voluntarily resigned under a cloud and even accused of criminal wrongdoing.
Was there a scientific study that proved such extreme tactics have improved
patient safety?
At some large pharmacies, where there are
some discrepancies in the controlled substance inventories, all of the techs
and the pharmacist on a shift are suddenly taken by car to a facility to give
urine and/or hair samples to screen for drug metabolites and all of the
employees, guilty or innocent, comply! Wow, nothing says I respect you and
value your professionalism quite like that! Way to build employee loyalty and
morale! I personally know of pharmacists who developed clinical depression
after that treatment.
What if a nurse takes my advice and goes
downhilling at Whistler injures herself and a doctor prescribes her Tylenol
with codeine for 10 days? A frenemy nurse hears that she was hurt on
vacation and takes the opportunity to inform a supervisor she looks tired or
sleepy. The next thing you know, a urine sample is demanded and the nurse is
discharged because she has metabolites of codeine in her urine and the hospital
didn’t have codeine on the list of drugs she was prescribed at the time
of hire. State and federal laws prevent an employer from discriminating against
able employees with medical conditions or handicaps. Many employees don’t want
employers to know what meds their doctors prescribe for them because they fear
they will be stigmatized or passed over for promotions so they don’t list them
for urine testing purposes. When you list your personal prescribed medications,
the employer can make inferences about your mental and physical health,
sometimes the conditions you have would be humiliating if others knew. Further,
if you vacation where marijuana is legal and you indulge, isn’t that your own
business on your private time? Otherwise excellent careers for health
professionals have gone down the tubes over false positive urine tests for anything from opiates to marijuana,
etc. Young adults are growing up thinking this perversity is “normal” in our
society; same as having all of your
private communications recorded and analyzed.
And a special reminder to all of the
citizens out there who answer questions from police officers in the absence of
counsel when they do not need to, take this quiz:
You are a 20-year-old pharmacy student at
Ferris State. You are at a private house party (you are not driving a car) and you have consumed a couple of beers. A
police officer enters the party and demands that you “blow” into his
breathalyzer. You should:
(a) Blow into his breathalyzer and be
arrested and later convicted of “minor in possession of alcohol”. This
conviction complicates the rest of your life in multiple ways.
(b) Say to the officer “no thank you”,
turn and walk home. You wake up the next morning, say “that was a close one...”
and resolve to wait until 21 to drink responsibly and continue on to a
productive and fulfilling personal and professional life.
(c) You attempt to charm the officer
with a rambling explanation of your entire life and why he should just let you
go. He doesn’t, you “blow” and go to jail.
Federal
Criminal Prosecution
Here are just some of the reported monetary
settlements by mega corporate health providers for criminal health care fraud.
Merck: $650 million for nominal pricing fraud
Pfizer: $2.3 billion for fraudulent off-label
marketing
Allergan: $600 million for off-label marketing of Botox
GlaxoSmithKline: $650 million for
adulterated drugs
GlaxoSmithKline: $3 billion for
illegal marketing of
prescription
drugs
Omnicare: $120 million for kickback charges
Some of the corporations are
repeat offenders. Again, no executive goes to prison and no revocation of
corporate charter.
Locally scores of health
practitioners are indicted for small
dollar health care fraud and they go to prison.
Why can’t they pay a fine and
return to practice like the big companies? What could the distinction be? Do
you know?
Miscellaneous
I
have three openings for annual retainers.
Additionally,
it is important to remember that every health professional should have a will
or trust. If you run a pharmacy, a corporate succession plan is mandatory
because no one can protect or anticipate when they might become disabled,
injured seriously or when they may pass away. Don’t leave it for your family to
litigate the matter when you can have me draft a plan now.
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There
are so many little known, complex federal and state laws that it is never
a good idea to answer questions from any branch of law enforcement
without an attorney. You may unknowingly make an innocent remark that will lead
you to become ensnared in a larger investigation you don’t need in your life.
Law enforcement are like commercial fishermen that use gillnets to capture
desired fish but also kill little fish they aren’t supposed to.
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Please
read my blog at pharmacylawpro.com for expanded explanations of why innocent
people need their Fifth and Sixth Amendment rights.
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New blogs and back issues of the Pencak
Report are always available at pharmacylawpro.com.
Email your name and email
address to cpencak@pharmacylawpro.com
if you would like to receive the Pencak Report by email.
