Thanksgiving – America’s Day

(To mark the holiday we’d like to pass along a couple of personal messages. Have a great holiday, everyone! –CVH)

Thanksgiving is a verb, a word of action. Giving thanks demands that we acknowledge the people and events around us who have made our successes possible.  A quick look around gives us many reasons to give thanks and our thoughts turn gratefully to those who have made this progress possible.  A smile to a stranger, a ‘paying forward’ of a good deed, an acknowledgement of a good deed well received or a forgiving nod recognizing the humanity in all of us are all wonderful ways of giving thanks.

Let me borrow and paraphrase the famous lines from William Shakespeare’s The Merchant of Venice when Portia speaks to Shylock in Act IV, Scene I.

The quality of thanksgiving is not strained. It droppeth as the gentle rain from heaven Upon the place beneath. It is twice blest: It blesseth him that gives and him that takes.

You have to admit; that guy had a way with words!

Any internet search will bring you all sorts of insights into the ‘meaning of Thanksgiving’ or the history of harvest festivals around the world with each cultures particular ‘spin’ on the observance. For me personally, I have always marveled at the fact, that we as a country, community, society, family, etc. actually set aside a day to enjoy each other and count our manifold blessings.

As I reflect on this Thanksgiving Day, I think back to the many blessings we have encountered this past year. While they are too numerous to list here and now, they must not be ignored.

Each year brings new challenges. This year has certainly been no exception. We have met those challenges and look forward to meeting future ones with strength and honesty towards our mission. We entered this business with the purpose of bringing a better model to the pharmacy staffing world and are continuing to adjust our business model to best serve each specific market requirement. Thank you each and every one for your individual contributions to helping us meet those challenges.

For those of you who have blessed us with your pharmacy business or are contemplating our services, we thank you. For those of you who have represented our company or are awaiting new assignments, we thank you each. Your trust in allowing us to help fill your needs is deeply appreciated. We are honored.  I count each and every one of you as part of our blessings to which I am eternally thankful.

In this spirit we say simply and sincerely, thank you and best wishes for a Happy Thanksgiving.

Best regards,

Thomas Denton, CERS, CPC, CTS

Apex Medical Placements, Inc.

1-800-875-9022 Phone

1-800-875-9022 Direct Fax

Happy Thanksgiving! We’re all going to take a break this week to celebrate a holiday unique to America, a day that has become associated with the settlers at Plymouth who celebrated and gave thanks for their safe arrival to the New World. But the holiday did not become official until 1863 when President Lincoln proclaimed that a national day of thanksgiving should be celebrated annually. For me, the date of Lincoln’s proclamation, October 3, 1863, has always spoken to the holiday’s true significance. We were deep in the middle of the bloodiest, most divisive conflict of our history. The Civil War would not be over for another two years and yet Lincoln did not wait until its conclusion to designate a national day of gratitude. Instead he chose to reach down into the death, suffering and despair and seize upon everything that we, as a nation, still had reason to give thanks for. In July of that year 75,000 men of the Confederacy confronted 97,000 Union soldiers in Pennsylvania and fought the battle of Gettysburg. The total number of killed, wounded and missing after the three days of fighting totaled a staggering 50,000. Yet in his proclamation Lincoln said, “The year that is drawing towards its close has been filled with the blessings of fruitful fields and healthful skies. To these bounties, which are so constantly enjoyed that we are prone to forget the source from which they come, others have been added, which are of so extraordinary a nature that they cannot fail to penetrate and soften even the heart which is habitually insensible to the ever watchful providence of Almighty God.”

Likewise may we, amidst all the struggles and disappointments of the present day, never fail to recognize America’s many blessings. There is much to be grateful for. From all of us here at Apex Medical Placements, have a warm, wonderful Thanksgiving!

Cynthia von Hendricks, Administrative Assistant

Apex Medical Placements, Inc.




To Get the Right Answers, Ask the Right Questions

October was American Pharmacist Month and hopefully it raised awareness about pharmacy and pharmacists. If you’re like most of us you’re probably annoyed when your doctor hustles you in and out of his exam room in 15 minutes flat. But I’d bet even 10 minutes is too long to wait when you’re picking up a prescription. Once the doc has written that prescription we tend to put our brains in neutral. But what do you really know about that pill you’re about to pop? Unless you have a very unusual physician it’s likely that he or she doesn’t (1.) discuss your prescriptions with you and (2.) doesn’t know a whole heck of a lot about the benefits and downsides of the drugs he prescribes. There is, however, a remedy for this rather scary and pathetic situation: your friendly neighborhood pharmacist is a drug expert and the master where everything pharmaceutical is concerned. You just need to know which questions to ask:

Why am I taking this medicine? Now there’s a concept – actually understanding why a particular drug has been prescribed for you. Yet you’d be amazed at how many people never think to ask. My mother, for instance, a depression era baby, would never dream of questioning her doctor. In her generation it just isn’t done. What’s your excuse? All drugs, including prescription ones, are potentially dangerous – even lethal. Ask your doctor WHY you need the medicine being prescribed and how it’s going to help you. Discuss your concerns and get all the information so you can decide if you want to take it. (Yes, it really is your decision.) If you don’t want to take it, ask your doctor for a treatment that is more acceptable. If your doctor resists, ask a pharmacist. Oh, and then find a different doctor.

Brand name or generic? If you weren’t confused enough already, that drug you’ve been prescribed has more than one name. The first one, its brand name, refers to a new drug that has been developed by a pharmaceutical company. After a new drug is formulated, its maker files for a patent to protect against other companies copying and selling it. At this point the drug has two names: the generic, or the drug’s common scientific name and the brand name that makes it stand out in the marketplace. Think acetaminophen vs Tylenol.

Generics in the U.S. must match the brand name med in almost every way, both in the strength of the active drug it contains and in the way it acts in your body. This is called “bioequivalence”. The real differences lie in the way the products look (color and shape) and how much they cost. (Occasionally the difference in inert ingredients can present a problem for some individuals – ask your pharmacist if the generic is right for your situation.)

Brand names cost more because manufacturers want to cover the costs of researching, developing and advertising the drug – don’t think it’s because the brand name is superior.

How do I take this medication? According to Dr. Dorothy L. Smith, author and patient education expert, the cost to purchase all prescription medications in the U.S. in 2000 was about $111 billion dollars. But the cost to treat complications from home medication errors was $177 billion! Add to that another $100 billion to cover employer costs resulting from absenteeism and loss of productivity from home medication errors. Deaths from medication mistakes at home increased from 1,132 in 1983 to 12,426 in 2004 – an increase of more than 700%. Americans not only don’t know what they’re taking, they don’t know how to take it. Consider these tips:

§  The average person forgets 50% of their doctor tells them – ask your pharmacist to go over the instructions.

§  If you don’t feel comfortable talking to the pharmacist over the counter, ask for a private area. More and more pharmacies have them.

§  Lots of people stop taking their medicine because they think they’re allergic to it. Actually, they may have had a minor side effect. But allergic reactions can be very serious. Ask if you have a question!

§  Know how to take your medicine correctly. This might seem like a no-brainer, but “Take one tablet 3 times a day” doesn’t give you enough information. Your pharmacist can help you work your dosage schedule around your meal times and activities. Also, some medicines, such as asthma inhalers, are complicated to take. Your pharmacist can make sure the medicine reaches your lungs, not your throat.

§  Understand what to do if you accidentally skip a dose. Understand the sometimes serious side effects that can occur if you stop taking your medicine suddenly.

§  Are you taking OTC drugs or herbal remedies? They can interact with your prescription. Make sure you discuss them with your pharmacist.

§   Side effects – every drug has them. You need to know how recognize them because some are serious. Others are just annoying but you need to know how to manage them.

§  If you’re having trouble remembering to take your medicine, don’t be afraid to tell your pharmacist. They can help you find a way to jog your memory.

§  How long should take your medication? Some drugs are for a specific duration, like antibiotics or pain meds. Others, like heart medications or diabetes drugs, are for life. Stopping antibiotics prematurely can have dire consequences, so take your meds for the time prescribed and let your pharmacist know if problems develop. Never, never, never, stop taking antibiotics prematurely because you feel better and think you don’t need them!

How do I store this medication? Again, this is one of those things that seems obvious, but drugs can become toxic or inactive when stored improperly. Some drugs need to be refrigerated, for instance. Some are light sensitive or can degrade when exposed to the air. Most drugs should be stored in a cool, dark, dry place – they don’t do well in temperature extremes or in high humidity (like bathroom cabinets). Combining different meds into one bottle or vial is not a good idea, nor is keeping them in a plastic bag where they may break open or get crushed. Transdermal patches should be discarded carefully so kids and dogs don’t get into them. And you know those pesky childproof caps? If you don’t have kids around, you may not want them. I had no idea that the white plastic locking kind can simply be turned upside down and screwed on until my pharmacist pal showed me.

How do I choose a Pharmacy? Most people choose a pharmacy based on location or convenience (like the Walgreen’s around here that also sell booze – no, really!). But there are a ton of other services you may not know you want until you need them:

 §  What are the pharmacy hours? Are they open when you might need them most – like on holidays or in the middle of the night?

§  Does the pharmacy deliver? What are the restrictions? Charges?

§  How are emergencies handled during and after business hours? Is there a dedicated emergency phone number?

§  How long does it take to have a prescription filled?

§  Does the pharmacy stock the drugs you take?

§  Does the pharmacy staff look stressed? Are there long lines at the counter? (If you suspect staffing problems behind the scenes, don’t risk an error or sacrifice service – find another pharmacy.)

§  Is there a drive-through? Pharmacists hate them. I love them. (Never equate your pharmacist with the burger flipper at McDonald’s. She’s a professional and protecting your health and safety takes time.)

§  Are there exceptions to the kind of insurance they accept?

§  Do they accept credit cards? Do they have credit accounts available?

§  What health services are offered? Vaccinations? Blood pressure or cholesterol screening? Medication management for chronic conditions like diabetes?

How do I choose a pharmacist? Choose a pharmacist, you ask? I just go over to CVS and take my chances! Pharmacists don’t just put pills in a bottle. The role of today’s pharmacist is expanding and involves establishing a relationship with the patient to develop care plans for drug therapy. Ask friends and family for a pharmacist referral. Then get to know him and make sure he knows your medical history. Some other things to think about:

§  How does the pharmacist handle the phone? Is she harried? Disinterested? Or polite and informative?

§  Does the pharmacist have any specialties in disease management? This can be a real advantage if you have a chronic illness such as heart disease.

§  Is he easy to talk to? Does he take the time to explain new medications and answer your questions in a way you understand?

§  Select a pharmacist with the same care as choosing a doctor. A good one will go the extra mile for you when it really counts.

Your pharmacist is the real drug expert and is probably a lot more accessible than your doctor. So take an active role in your own health care – get to know your pharmacist and get to know your meds. It could save your life or the life of someone you love some day.

Next week – the questions you’re better off NOT asking the pharmacist!



Up in Smoke III – Medical Marijuana’s Got a Real Bad Rep

Consider the common cold. When you feel really rotten and reach for something to help you feel better, what is it that makes you choose a particular medicine? Say you ache all over, your head is stuffed up, and you have a fever, a cough and a sore throat. You’re presented with some options – a traditional Chinese extract made from astragalus root, a Mexican tea made from garlic, lime peel and honey, or Robitussin Multi-Symptom Cold Formula – which would you choose? Why? What is it that motivates you to pick one remedy over another? Our beliefs and experiences undoubtedly play a role in shaping our view of a medicine as legitimate. But the important question is how those ideas of legitimacy benefit us…or not.

A couple of weeks ago I wrote about the crackdown by federal authorities in California on medical marijuana dispensaries. An article in the N.Y. Times last Sunday described exactly what the feds are up to: “The Treasury Department has forced banks to close accounts of medical marijuana businesses operating legally under state law. The Internal Revenue Service has required dispensary owners to pay punitive taxes required of no other businesses. The Bureau of Alcohol, Tobacco, Firearms and Explosives recently ruled that state-sanctioned medical marijuana patients cannot purchase firearms.

United States attorneys have also sent letters to local officials…stressing their authority to prosecute all marijuana offenses. Prosecutors have threatened to seize the property of landlords and put them behind bars for renting to marijuana dispensaries. The United States attorney in San Diego, Laura E. Duffy, has promised to start targeting media outlets that run dispensaries’ ads.”

When Obama ran for president in 2008, he defended the use of cannabis as medicine and said he wouldn’t use the Justice Department to override state laws concerning it. But then he re-nominated a Bush appointee, Michele Leonhart, as the head of the Drug Enforcement Administration, so it’s no surprise that Obama’s policy on cannabis is the same as Bush’s, despite his campaign rhetoric. Leonhart has retained the classification of cannabis as a Schedule I drug with “no currently accepted medical use in treatment in the United States.”

When you think of cannabis, or more specifically, one of its street names: marijuana, pot, grass, weed – what comes to mind? Hippies? Mexican drug cartels? The kooky California counter-culture? Though the history of cannabis as a medicine goes back thousands of years, it was maligned as the vice of dark-skinned foreigners, destined to corrupt all that is fair and white and good in 1920’s America. In the 60’s it became associated with anti-establishment rebellion, violence and mayhem. Maybe you’re old enough to remember Cheech and Chong’s pot humor in the 70’s. I still have the Big Bambu album somewhere, complete with the giant rolling paper that came with it. Really, cannabis can’t be taken seriously as a medicine! Can it?

In March of 2009 President Obama attended a televised online town hall. Of the thousands of questions that were received in advance, the topic of whether the legalization of cannabis would improve the economy ranked fairly high. Obama didn’t take the subject seriously and said laughingly, “I don’t know what that says about the online audience. But no, I don’t think that is a good strategy to grow our economy.” No wonder cannabis has an image problem. Yet in 2004 at an event at Northwestern University then Illinois politician Obama told the crowd, “I think that the war on drugs has been a failure, and I think we need to rethink and decriminalize our marijuana laws.” Nothing has changed much since the Marihuana Tax Act of 1937 – cannabis is still the center of a game of political football.

I don’t know where Michele Leonhart gets her information, but there have been hundreds of studies conducted on the medicinal uses of cannabis. It has been documented as effective for the treatment of nausea, vomiting, premenstrual syndrome, unintentional weight loss, insomnia, and lack of appetite. It’s used to treat spasticity, neurogenic pain, movement disorders, asthma and glaucoma. It has been found to relieve certain symptoms of multiple sclerosis and spinal cord injuries. It may also  prove useful in treating (are you ready?) inflammatory bowel disease, migraines, fibromyalgia, alcohol abuse, collagen-induced arthritis, atherosclerosis, bipolar disorder, colorectal cancer, depression, dystonia, epilepsy, digestive diseases, gliomas, hepatitis C, Huntington’s disease, leukemia, skin tumors, methicillin-resistant Staphylococcus aureus, Parkinson’s Disease, pruritus, post-traumatic stress disorder, psoriasis, sickle-cell disease and sleep apnea. And yes, controversies remain. Should it be smoked or synthesized into pill form? What are the side effects and benefits of both? How should growing of the plant be regulated? How can the final product be standardized? Should it be? No doubt such questions arose in the long journey between the poppy fields and the manufacturing of morphine and Vicodin. But today opioids are accepted as serious medicine, approved by the FDA, prescribed by MD’s and dispensed by pharmacists in neat, labeled, tamper-proof plastic bottles. Where cannabis is concerned, we got stuck on the road someplace between William Randolph Hearst and the last doobie you smoked underneath the high school bleachers. And not only can cannabis assist in the treatment of pain and disease, it can do it without the toxic effects of many of the medicines we consider “legitimate”. According to a 1988 statement by the U.S. Department of Justice, “There is no record in the extensive medical literature describing a proven, documented cannabis-induced fatality. In practical terms, marijuana cannot induce a lethal response as a result of drug-related toxicity.”

If the ability of cannabis to ease pain and suffering hasn’t convinced us of the need to decriminalize its use, its potential as an economic powerhouse should. The illegal import of drugs into the United States is a multi-billion dollar a year industry with all of the profit going to criminal organizations. If cannabis were legalized and regulated the huge expenditure on the drug war and black market sales could be turned to far more practical applications. It’s interesting to note that economist Milton Friedman is a staunch supporter of the legalization of cannabis. He joined with 500 other economists in signing “An Open Letter to the President, Congress, Governors, and State Legislatures” which states that the legalization of cannabis “would save $7.7 billion per year in state and federal expenditures on prohibition enforcement and produce tax revenues of at least $2.4 billion annually if [it] were taxed like most consumer goods. If, however, marijuana were taxed similarly to alcohol or tobacco, it might generate as much as $6.2 billion annually.”

$14 billion ain’t hay. That doesn’t even include the proceeds of the legalization of agricultural hemp and its spinoff industries. Profits there, according to Dr. Dale Gieringer, author and state coordinator of the California NORML (National Organization for the Reform of Marijuana Laws), are anywhere from an additional $6-10 billion annually. And don’t forget jobs. In an era of 9% unemployment our consumer-driven economy would have a huge boost from the thousands of jobs that would be created in the agricultural, medical and manufacturing fields. I don’t know about you, but I hear a lot of talk these days that America is broke and that we just can’t afford to fund public education, infrastructure repair, health care, public transportation or social services and that we must cut back on the number of public sector workers like cops, nurses, firemen and teachers. Considering the decisions we make, the continued criminalization of cannabis among them, its little wonder our national finances are in a mess. I was more clear-headed than this back in the days when I smoked…and inhaled.