HEALTH

The Harry and Louise ad I would like to see

BY Rob Eder

Louise: [Sneezing and coughing incessantly.] HAAAA-CHOOOOOOO! Oh, Harry! Can you believe the doctor won’t be able to see me until a week from next Monday?

Harry: A week from next Monday? That’s almost two weeks from now. That seems like an awfully long time to wait—what if it’s something serious?

Louise: At this rate, whatever it is, I’ll either be all better or stone dead by the time I get an appointment!

Harry: What about this stuff I was reading about these clinics that operate at the local pharmacy? From what I understand, a bunch of chains have set up these clinics in their stores—CVS, Walgreens, Target, Kroger. Those chains all have stores around here.

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you!

Louise: Thanks. Ya, I know; I heard about those clinics. Dr. Hedenbutt says the clinics are bad for America. Dr. Hedenbutt says it’s like going to McDonalds for health care.

Harry: How is it like going to McDonalds? They don’t serve hamburgers.

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: Don’t mention it. Why did Hedenbutt say the clinics are like McDonalds?

Louise: He said because they are cheapening the medical profession.

Harry: Cheapening the medical profession? Did he say how?

Louise: Well, now that you bring it up, he didn’t really get into it.

Harry: Why?

Louise: Well, Harry! He’s a busy man—I mean, after all, he DOES have other patients, and he had been talking to me for almost three minutes at that point!

Harry: THREE minutes! It only took Hedenbutt THREE minutes to give you an entire physical examination?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: [Handing her a tissue.] You’re welcome. So, let’s get back to this three-minute physical Hedenbutt gave you.

Louise: Well, Dr. Hedenbutt didn’t actually perform the exam…

Harry: He didn’t?!

Louise: No.

Harry: Who did?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: You’re welcome. Who did?

Louise: That lovely young woman who works with him. I can’t remember her name. She’s been with Hedenbutt for the last few years. She’s just great! She takes lots of time to talk to me about my blood pressure and whether I am keeping away from cigarettes and getting enough exercise. She actually gave me a tip on a low-impact aerobics class they teach at the Y. I think she’s the one who writes most of my prescriptions. She is really smart and so good-looking, too; she’d be just perfect for Harry, Jr. I bet she’s a good cook, and she and Little Harry would make us such beautiful grandchildren…

Harry: Leave Harry, Jr., out of this. So, this one, this “Super Girl”… She’s a doctor?

Louise: No, she’s something else, some kind of a nurse. A nurse-something… An NB? Or maybe it’s NC?

Harry: You mean an NP? A nurse practitioner?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry.

Harry: You’re welcome.

Louise: Yes, that’s it—a nurse practitioner.

Harry: Did Hedenbutt mention that those are the people that work in these retail clinics? That it’s mostly NPs?

Louise: No, he didn’t say anything about that. He just said they were cheapening medicine.

Harry: Well, from what I read, a trip to one of these clinics is definitely cheaper than a visit to Hedenbutt. The last time I was there and they drew my blood, I thought it was in payment. He might as well let me pay him in blood since he stopped accepting our insurance. Meanwhile, I read that the clinics take most major insurance plans, and some plans—including ours—actually offer a lower co-pay for a clinic visit.

Louise: Well, Dr. Hedenbutt said that if he and a couple of his doctor friends have their way, the government would shut down those clinics.

Harry: That explains a lot.

Louise: What does that explain?

Harry: It explains why there are no clinics around here. So, anyway, did Hedenbutt’s office say why it’s going to take so long to get you an appointment?

Louise: HAAAA-CHOOOOOOO!

Harry: Bless you.

Louise: Thanks, Harry. They are just so backed up ever since that nice young NB, uh, ND…

Harry: NP!

Louise: Yeah, the NP—she moved about two weeks ago to a nice town outside of Chicago. She left about two weeks ago.

Harry: Working for another doctor?

Louise: Not sure—don’t think so. Sounds like a fancy operation—Take Care Health Systems, I think it was.

Harry: Louise, that’s one of those retail clinics I’m talking about.

Louise: Really?

Harry: Yes, Louise. You know, I just wish someone would set the record straight on these retail clinics because health care is really messed up in this country, and I think these clinics could be doing more to help us fix it. If only people like Hedenbutt would just stop spreading lies about the clinics, we might be able to get you checked out right now instead of sitting here talking about it.

Louise: HAAA-HAAAA … HAAAA-CHOOOOO!

Harry: Gesundheit.

Louise: Thanks, Harry.

Harry: You’re welcome, Louise.

Correction: In the July 20, 2009, issue of Drug Store News, a photo on page 6 incorrectly listed Kirk Hodgdon, principal, growth catalyst for Bolin Marketing, as an associate of Carma Labs.

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Op-ed: Adherence deserves historic collaboration

BY Steve Anderson

I took an opportunity at the 2009 NACDS Annual Meeting to reflect on words spoken 70 years earlier by then-NACDS president Nate Shapero of Cunningham Drug Stores. His words at the second annual convention of NACDS, on May 5, 1939, could have been delivered today: “At our first annual convention last year, I sounded the keynote of the ‘Triumph of Cooperation’ … our association … is an effective instrument for the elimination of the evils in our industry, and for the development of a sound relationship between the manufacturer … the producer … the chain store … and between ourselves and the public.”

 

If there is any doubt that there are challenges that need to be overcome, and that there is a need for collaboration, just consider the attacks that are levied against pharmacy and pharmaceutical suppliers. There are those who say that pharmacists perform only a dispensing function. About manufacturers, some remain fixated in their rhetoric on what they call the high price of prescription drugs, without any context related to research costs, the public benefit and the costs avoided by treatment of chronic disease.

 

 

It just may be that the concept of adherence is the bridge to greater understanding among policy-makers and the public of the dual value of pharmacy and pharmaceuticals. As this understanding increases, so will the appreciation of pharmacists, pharmacies and medications.

 

 

Medications are important to the management of chronic diseases that require long-term or lifelong therapy. Pharmacists are uniquely qualified as medication experts to work with patients to manage their medications and chronic conditions, and play a key role in helping patients take their medications as prescribed.

 

 

Nonadherence with medications is a significant problem. According to a report by the World Health Organization, in developed countries only 50% of patients with chronic diseases adhere to medication therapies. In the United States, failure to take medications as prescribed has been estimated to impose more than $177 billion dollars annually in direct and indirect costs. Poor adherence leads to unnecessary disease progression, reduced functional status, more extensive and more expensive medical care, a lower quality of life and premature death.

 

 

Studies have demonstrated that pharmacist-provided medication therapy management services can help. In one frequently cited study, every $1 invested in MTM services reduced overall healthcare costs by more than $12. We must spread the news about this opportunity to reduce healthcare costs, while improving patient care and quality of life.

 

 

This is why NACDS is working with allied organizations for enhancement of the MTM benefit in Medicare Part D. That also is why the NACDS Foundation is supporting educational initiatives, along with the Pharmaceutical Research and Manufacturers of America, that are designed to enhance the public understanding of factors affecting medication adherence. 

 

 

Together, we must boost appreciation for the value that comes from proper utilization of prescription drugs. During the current healthcare reform debate, NACDS has a lot to offer as a retail association. We can make a personal and credible pitch for the overall benefits of the kinds of products and services for which suppliers are responsible. By definition, pharmacies and pharmacists are the segment of the supply chain that is closest to the people.

 

 

In last year’s Gallup survey that measured the public’s perception of professional integrity, pharmacists came in second, right behind nurses. Pharmacists have been in the top three each of the past six years. Our industry is blessed with ideal ambassadors for mutual issues of importance, which directly affect the well-being of patients and the entire healthcare system.

 

 

Nate Shapero was on to something when he spoke in 1939 about NACDS’ ability to leverage productive relationships. He did not live in Utopia any more than we do. He was a businessman — struggling with economic turmoil, competition, business relationships and responsibilities to view his world broadly, at the helm of an industry association. But these factors did not delay, derail or deny the vision and pursuit of a common purpose. That is a concept that must not be lost on us today.

 

 

On behalf of NACDS, we look forward to working with you, for the ultimate good of the patients we serve.

 

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CDC releases updated flu guidance for back-to-school

BY Michael Johnsen

ATLANTA The Centers for Disease Control and Prevention on Friday released updated guidance for school administrators and state and local governments to help decrease the spread of flu among students and school staff during the 2009-2010 school year.

Approximately 55 million students and 7 million staff attend the more than 130,000 public and private schools in the United States each day, the CDC noted, representing about one-fifth of the country’s population.

In a nutshell, in lieu of closing schools outright at the first hint of influenza-like illness, CDC is suggesting that sick kids and teachers stay home and that children and teachers attending schools emphasize illness etiquette — i.e., washing hands, covering mouth when coughing/sneezing and proper disposal of tissues.

The CDC is suggesting that ill students and staff be quarantined in a separate room until they can be sent home. CDC also recommends that they wear a surgical mask, if possible, and that those who care for ill students and staff wear protective gear such as a mask.

Based on the severity of 2009 H1N1 flu-related illness thus far, the CDC guidance recommends that students and staff with influenza-like illness remain home until 24 hours after resolution of fever without the use of fever-reducing medications.

School staff should routinely clean areas that students and staff touch often with the cleaners they typically use. However, special cleaning with bleach and other non-detergent-based cleaners is not necessary, the CDC stated.

The guidance also provides a checklist for making decisions at the local government level, which is usually tasked with the decision around possible school closures. The decision to dismiss students should balance the goal of reducing the number of people who become seriously ill or die from influenza with the goal of minimizing social disruption and safety risks to children sometimes associated with school dismissal. Based on the experience and knowledge gained in jurisdictions that had large outbreaks in spring 2009, the potential benefits of preemptively dismissing students from school are often outweighed by negative consequences, including students being left home alone, health workers missing shifts when they must stay home with their children, students missing meals, and interruption of students’ education. CDC expects that the overall impact of 2009 H1N1 should be greater as compared to earlier this spring, and school dismissals may be in fact be warranted depending on the disease burden and other conditions.

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