Tuesday, May 31, 2011

Twitter exchange

Recently I had a brief exchange on Twitter about HR 891, the Medication Therapy Management Benefits Act of 2011. Somebody had posted that another Congressman had signed on as a cosponsor of the bill.

I commented that we don't need any more cosponsors, we need action from the committees. Their response was "The former fuels the latter. Onward!"... meaning that more sponsors will get the bill moving out of committee.

I don't agree. The MTM bill has been introduced previously, only to die in committee. We can have dozens of representatives cosponsor the bill, but if it doesn't leave the committees it dies.

Here are the names of the members of the committees where the fate of the MTM bill rests. Lobby them, and if/when the bill makes it out of committee we can work on our individual Congresspersons.

House Energy and Commerce Subcommittee on Health:

Joe Pitts, PA Chair
Michael Burgess, TX Vice Chair
Ed Whitfield, KY
John Shimkus, IL
Mike Rogers, MI
Sue Myrick, NC
Tim Murphy, PA
Marsha Blackburn, TN
Phil Gingrey, GA
Bob Latta, OH
Cathy McMorris Rodgers, WA
Leonard Lance, NJ
Bill Cassidy, LA
Brett Guthrie, KY
Joe Barton, TX
Fred Upton, MI
Frank Pallone Jr, NJ
John D. Dingell, MI
Edolphus Towns, NY
Eliot Engel, NY
Lois Capps, CA
Jan Schakowsky, IL
Charles A. Gonzalez, TX
Tammy Baldwin, WI
Mike Ross, AR
Anthony D. Weiner, NY
Henry A. Waxman, CA

The bill is also sitting in the Committee on Ways and Means.

Dave Camp, MI Chair
Wally Harger, CA
Sam Johnson, TX
Kevin Bradley, TX
Paul Ryan, WI
Devin Nunes, CA
Pat Tiberi, OH
Geoff Davis, KY
Dave G. Reichert, WA
Charles W. Boustany Jr, LA
Peter J. Roskam, IL
Jim Gerlach, PA
Tom Price, GA
Verne Buchanan, FL
Adrian Smith, NE
Aaron Schock, IL
Lynn Jenkins, KS
Eric Paulsen, MN
Kenny Marchant, TX
Rick Berg, ND
Diane Black, TN
Sander Levin, MI
Charles Rangel, NY
Fortney Pete Stark, CA
Jim McDermott, WA
John Lewis, GA
Richard E. Neal, MA
Xavier Becerra, CA
Lloyd Doggett, TX
Mike Thompson, CA
John B. Larson, CT
Earl Blumenauer, OR
Ron Kind, WI
Bill Pascrell Jr, NJ
Shelley Berkley, NV
Joseph Crowley, NY

These are the people who we need to lobby. If we want more cosponsors, work on these Congresspersons.

Regardless, if the bill doesn't make it to the House floor it dies. Stop sitting on your hands, hoping somebody else does the dirty work.

Do something for your profession. Contact these Representatives.

Sunday, May 22, 2011

New poll....prescription volume

Recently my pharmacy manager has been instructed to decrease the pharmacist staffing at our location by 0.5 FTE. Corporate has guidelines on how many prescriptions a pharmacist can check per hour.

I am not in agreement with corporate guidelines. I'm curious to see what pharmacists in the field think are SAFE volumes of prescriptions that can be filled.

Please take a moment to vote on the poll located on the right side of the page.


Tuesday, May 17, 2011

Recent encounter of the MTM-type

Well, it has been a while since I've sat down to offer some thoughts here on the blog. Over the last month or so work has been extremely hectic. One of the other pharmacists has been on medical leave and corporate has decided that it's not necessary to replace a full-time pharmacist with equal hours. We're lucky if we get 20 hours of floater pharmacist each week. With that, after any given day of work I haven't been feeling like sitting down with the blog.

I took a week off to attempt to recharge. During this time off, I tried to think about pharmacy as little as possible. If you follow me on Twitter, you would have seen very few pharmacy-related comments. Not thinking about pharmacy is relaxing, but when you are attempting to land clients for a medication therapy management business, that's not necessarily a good thing.

Especially after having discussions with pharmacists at the national level who are promoting the MTM side of pharmacy. After talking with these people, I get recharged on the MTM front. But then I return to my employer where I get beaten down with the dispensing side of the profession. With the lack of pharmacist hours, I haven't been able to offer even basic counseling to my patients let alone even think of the advanced level of patient care that is required with MTM-type services.

All that being said, at the end of my week off I was able to have an exchange that renewed my passion for educating patients and offering MTM services.

Every other week, my wife and I meet with four other couples from our church for our small group. We attend a large church that doesn't offer traditional Sunday school classes for adults. Instead, we meet in small groups to have, for the lack of a better description, a Bible study. It's not just a Bible study though, we are a support group for each other as we go through life.

When we were wrapping up Sunday night, one of the women in my group approached me with a question about her father's drug therapy. He has been having episodes lately where he has been passing out and falling and she was wondering if a change in his medications a few months ago might be contributing to the falls.

We talked for about fifteen minutes as she shared what had been happening and I questioned her further to get more information. She had contacted her father's cardiologist and primary care physician, but they were not able to determine a possible cause of the fainting spells and falls.

Then she said the magic words that may have helped us figure out what the cause of his falls might be. About two months ago, her mother decided that he needed to eat healthier. Instead of a sandwich, fruit, and pretzels for lunch, she was now feeding him chicken breasts and salad.

Now this would normally be good, but they didn't factor in one thing.....he has been on a fixed insulin dose (Novolin 70/30) for about 30 years.

Factoring in the time of day that his spells have been occurring (mid-afternoon) and his recent change in diet, our working hypothesis is that he is basically having hypoglycemic episodes every afternoon. I made a couple suggestions for her to relay to her parents and we'll see where things go from here.

This is an example of how pharmacists can have an impact on the lives of our patients, if we are able to take the time to talk with our patients. Recently some of the chains have started making moves that appear to be advancing the cause of MTM. I would like to remind these chains that the single-most important thing that they can do to allow pharmacists to provide these services is to give the pharmacist TIME to talk with the patients. Verifying 30+ scripts per hour does not allow the pharmacist the opportunity to have these discussions that can impact the lives of our patients.