This One's For The Kids.

http://drugmonkey.blogspot.com/2016/02/this-ones-for-kids.html

Because you need to know what's waiting for you on the other side of a pharmacy degree, and no one else is gonna tell you.

Your professors aren't gonna tell you.

The corporate hacks you interview with aren't gonna tell you.

The American Pharmacists Association isn't gonna tell you. They're there to let you know provider status will create a world where every child gets a puppy and unicorns frolic in the pastures shitting rainbows all day long.

But you need to know. So when I saw this out on the internets I figured I'd put it here where some of you kids would see it. There's not one word in here that surprised me. As a matter of fact, I'd be surprised if you weren't treated to some variation of this if you make the mistake of slinging pills for the corporation. Read it and weep. Then figure out what you're gonna do about it.

This was around the point where back in the bad old days I would have put in some sort of joke about how it was too late for me, but you can still save yourselves.

But it wasn't too late for me. Which I guess means this post isn't just for the kids. I sure as shit didn't have any special entrepreneurial skills  when I set out on my own. I didn't even know what happened to the money after I dropped it off to the community college hack on my way out the door.

Yet here I am am. Three years now and counting. If it's too late for you to find another major I have every reason to believe you could do it too.

No one at CVS probably even read this letter. More people will see it here than at their corporate headquarters. Nothing will change there, but that doesn't mean it has to be this way.

It doesn't. You don't have to accept this.

The letter's long and maybe not of much interest to people outside the profession, but if you're thinking about your major, or if god forbid you're close to accepting a job with one of the chains, you need to read every word.

Then figure out how to keep this from happening to you.

__________________________________________________________________


To Whom It May Concern,

Please accept this letter as notice of my resignation from the position of pharmacist at CVS Health.

As per the terms of my employment contract, I will continue to work for the company for the next 2 weeks, completing my employment on February 26, 2016. If there are any areas in particular you would like me to focus on during my notice period, please let me know. As always, I will continue to give my best effort – I want to leave my team in the best possible situation, and I hope that the new pharmacy manager gets off to a good start.

Although this should be difficult decision to make, I have recently come to recognize that it is really the only decision left, largely due to what I feel is a serious deficit in my immediate supervisor's management abilities. I recognize that she is a strong pharmacist, and I have a lot of respect for her as such, but I have spent the last 3 years under her supervision becoming increasingly frustrated with the state of our district and the way it has been handled. I can no longer keep these feelings of frustration and hopelessness to myself, and will detail some of them below. I hope you will understand my reasons for moving on.


I will start with the broader issues, involving the company as a whole. Let me lead off by saying that I have worked for CVS for 10 years, from intern to pharmacy manager. I have worked in 3 different states, under different management teams, and weathered many storms with and for CVS. I had a colleague, who has about the same tenure, say to me the other day, “I used to recommend that all of my friends try to get jobs here. It was such a good company to work for. Now I tell them to stay far, far away.” I hear this sentiment echoed over and over again throughout the world of retail pharmacy, from those who were previously employed by CVS and from those of us who’ve stuck around, faithfully holding up our ends of the bargain and hoping CVS would see the error in their ways and do the same. The downfall of CVS as a desirable employer began when Tom Ryan retired. His philosophy was always people-driven. He wanted to run a healthcare company, one that took care of and did right by its patients. He wanted us to be able to provide the best possible patient care, and valued our customers as people, not as dollars. He valued his employees as individuals – raises were merit-based and people were recognized for their accomplishments, encouraged, and rewarded.


When Tom Ryan’s reign ended and Larry Merlo took over, it did not take long for their corporate philosophy differences to become apparent at the ground level. Technician hours were slashed; business metrics became the focus over patient satisfaction metrics; employee satisfaction declined and turnover went through the roof; employee benefits were cut, including the extension of the tenure required to achieve an extra week of vacation, stock options, and hiring everyone in at part-time employment to ensure that they didn’t have to be paid health insurance benefits; CVS acquired Caremark (not sure how the FTC allowed this) so that they could force their insurance recipients to use their own pharmacies and as such could lower their service standards to abominable levels, because patients had no choice but to use CVS. They no longer represent what ANYONE went to pharmacy school for, except maybe the paycheck. We are no longer healthcare providers – we have been relegated to being dispensing machines without regard to our own safety or that of our patients.


Now, these corporate changes began several years back. They are not my primary reason for leaving, despite the fact that they are significant. I came to terms with working for one of the corporate giants that was selfishly destroying our society by hurting employees and customers so that the upper echelons of management could bring in money hand over fist. I told myself that it was just the unfortunate way that capitalism in the US has gone, and that it was out of my control. My true reasons for leaving, now, after all this time, are more personal and immediate. Since my prior pharmacy supervisor, Sarah Freytag (the best manager I have ever had the pleasure of working for) moved into a corporate position a few years ago, my district has steadily declined under the management of [pharmacy supervisor name]. I have been underwhelmed with the quality of the management team we’ve had since her departure, and have become increasingly frustrated with the lack of response to the district’s decline.


It starts with respect. My current pharmacy supervisor treats her pharmacists and technicians with zero respect. As pharmacists, we are not even acknowledged as individuals with varying backgrounds and skill sets. Really, I think that it comes down to the fact that she does not spend enough time out in her district or talking to her pharmacists to know us as people, and doesn’t have the slightest inclination as to what we are individually capable of within our roles as retail pharmacists. As an example, a few months back I had text her to let her know that the website was down for our supplier, and I wasn’t able to place an order for the store I was filling in at. Her response was to call the store manager at home (after the order cutoff time had long passed) and ask her to call the store and talk me through how to place an order. I have worked for CVS for nearly 11 years – I have very successfully managed multiple pharmacies, and trained dozens of new technicians in the process. We have been ordering essentially the same way the entire time I’ve worked for the company. I thought to myself, “Does my immediate supervisor really think that I am that ignorant of the functions of my job? Would she really not know that sending an order is something that is well within my comfort zone, and not something that I need someone to talk me through? I can talk someone through just about any procedure in the CVS computer system with my eyes closed.” It really opened my eyes to the true lack of leadership that I was dealing with.


I’ve always felt like [pharmacy supervisor name] didn’t like me. I’ve never understood why, or what I was doing wrong. I’ve never had much feedback, positive or negative. In the 3 years I’ve worked under [pharmacy supervisor name], I’ve never even had the courtesy of having a review (which should be done annually, according to company policy). Last year, I received a very small percentage raise, much below the standard I had seen across my 10 years. I hadn’t had a review, so I checked my online personnel file where the written reviews are stored. I pulled up all of the reviews in there, 1 from Sarah and 2 from [pharmacy supervisor name]. The two from [pharmacy supervisor name] were both blank – all I could find was a rating of “Meets Expectations”. I emailed her to inquire about my raise amount since I had received an average rating, and asked if there was something I should be doing differently to improve my chances of getting a better raise next year. I never got a response.

Finally I called her, and she told me that she didn’t have anything for me to work on, but that my raise was low because my pay was high compared to other pharmacists in the company with the same title and tenure (PT Floater, 10 years of service). So now, my supervisor was telling me that it really didn’t matter what my performance level was or how hard I worked, that I was going to get a menial, ridiculous raise each year regardless, because I had worked very hard to move up earlier in my career and was now situated above some other people who hadn’t worked as hard. This year when I went to fill out my side of my review, my goals that [pharmacy supervisor name] had set for me revolved around “Manager Controlled Profits”, which involves script budgets and payroll management. Last year’s review was in March, and I had been floating since the previous September – the goals she had set for me weren’t even relevant to the job I was in. [pharmacy supervisor name] has so little respect for her pharmacists that she doesn’t even know who they are with respect to what positions they hold under her, and can’t even bother herself with writing out relevant reviews and goals for them.


But the lack of respect goes beyond that. Interns and technicians are essentially abused, and pharmacists are treated as pawns that should have no say or even opinion on their own career paths. I have seen technicians asked to take their day off to drive across town, pick up a cookie for a new pharmacist that was just licensed (and only one or two of the many, mind you) as congratulations, deliver said cookie to the pharmacist, and drive back home, all without pay.

I have seen countless interns on management rotations forced to work in stores as free labor, not to be shown a single thing about how to be an effective manager. I was even told by one intern that she was forced to personally deliver a narcotic prescription to an angry patient’s home – the patient’s regular pharmacy did not have her medication in stock, so the intern had to pick up her prescription hardcopy at the regular store, take it to another store to be filled, then drive it to the customer’s home. The patient was irate and somewhat unstable (I had spent over an hour on the phone with her myself a couple of days prior), and the intern was put in a very uncomfortable position where her personal safety was compromised so that the [pharmacy supervisor name] didn’t have to deal with the situation. Needless to say when [pharmacy supervisor name] asked her if she was interested in working for CVS, the answer was no.


As far as my personal situation goes, I have always been extremely flexible with CVS. I worked full-time until the birth of my daughter 4 years ago, and have since gone back and forth between full- and part- time, floater and pharmacy manager to meet the needs of my district. I have experienced swings from being told there are no hours for me to being asked to go back to full-time a couple of months later, and always taken it in stride and done whatever was asked of me. I have managed “challenged” pharmacies and turned them into “excellent” pharmacies,

I have been told by multiple pharmacy managers that I am the only floater they have ever had that will go above and beyond my daily duties of filling prescriptions to actually help them run their stores, and I have been told by technicians that I am the best boss they’ve ever had. I have a very strong urge to work my hardest and do my best regardless of whose store I’m in, whether the final outcome of how the store is doing is my responsibility or not, and I find my biggest frustration with floating was knowing that if I had more time at a store, I could make a bigger difference. This lead me to recently volunteer to manage a pharmacy that was really struggling, despite the fact that I have opened a small business and have a 4 year-old at home, and really want to be working part-time. I decided that for a while, I could sacrifice my personal needs to help my district succeed.


The back story on the situation at this store needs to be explained, as it is one of the major faults I see in [pharmacy supervisor name] management outlook. Since turnover has been so high under [pharmacy supervisor name], she has developed a habit of hiring the first person that walks in her door, regardless of their abilities as pharmacists or managers. She has also decided that the best way to get a pharmacy manager in a store that is in need is to force someone who doesn’t want the position and/or can’t handle the position to do it anyway. My biggest issue with this is with newly licensed pharmacists who have just graduated from school. They have no experience as a pharmacist, no experience being the one in charge of everything that’s going on that day, no experience handling being pulled in 8 different directions at the same time, and no experience managing people. They are not only being expected to magically become strong, fast pharmacists overnight, but they are expected to do so in very busy stores, and even as pharmacy managers.


In this particular store, 4 technicians were accepted into pharmacy schools at the same time. They were all scheduled to start their programs in August. The pharmacy manager was working on getting new technicians hired to replace them, and the staff pharmacist gave notice that he was moving away. The first terrible decision of a long series of terrible decisions was to, at the same time that the staff pharmacist and all the technicians were leaving, pull the pharmacy manager out and transfer him to another store. This left my store with no leadership, no permanent pharmacist, no technicians, and no one to follow through with the new hires. She decided to promote a staff pharmacist from another store (45 minutes away) and have him commute to my store to be the pharmacy manager, and put a newly licensed pharmacist in as the staff.

At the same time, the pharmacy manager at his original store gave his notice. [pharmacy supervisor name] decided that the best call was to let the transferring pharmacist remain at his original store as the pharmacy manager, and to force the newly licensed pharmacist to be the pharmacy manager at this store, with no steady partner for support. This was one of the worst decisions she could possibly have made, both for the pharmacist and the store.

Our district has plenty of experienced staff pharmacists who are plenty capable of being pharmacy managers. In this situation, I cannot understand why you would not take an experienced pharmacy manager from a slightly slower store and move them to this busy store, take an experienced staff pharmacist and promote them to a pharmacy manager at the slower store, and then take the newly licensed pharmacist and allow her to “get her feet wet” as a staff pharmacist. Dumping a new pharmacist into a management position is never a good idea. Dumping them into a super busy store is never a good idea. Combining the two is a terrible idea. Needless to say, the new pharmacist quit, leaving the store with no regular pharmacists and severely understaffed with technicians. I had been floating there some, and in an effort to keep the new pharmacist (who I had worked with when she was hired as an intern) I volunteered to take over as manager of that pharmacy, thinking that this would allow her to relieve some of her burden and be able to hang in there. I did eventually get put in as pharmacy manager, but not until a couple of weeks after the new pharmacist had left the company and the store continued to struggle, with no support from management.


About the time I was put in as the pharmacy manager at my store, [pharmacy supervisor name] went on maternity leave. I strongly believe that the only reason I was allowed to take the position was that she wasn’t there to say no – she had decided several months back that she would not staff me permanently in a store because she did not want to accommodate my schedule restrictions.

I was told by the district manager and the interim pharmacy supervisor that, when I expressed concerns with the way things had been managed to this point, that, “We’ve been doing things the [pharmacy supervisor name] way for a while now, and it’s obviously not working. Now we’re going to do things my way.” I was under the impression that meant that I would be staying in this store for several months, allowing them time to hire a staff pharmacist for the store, get the technician staffing under control, hire a pharmacy manager, make sure the pharmacy manager was capable of handling a store of this volume, and then make a transition once the store was stabilized.

Unfortunately, as soon as [pharmacy supervisor name] came back from maternity leave, this plan went out the window. In my first conversation with her after she was back, I asked when she could get me transferred into this store permanently, so I could access all of the tools that are only available to pharmacy managers. Her response was, “Why would I transfer you there? You aren’t the pharmacy manager there. You aren’t going to be the pharmacy manager there. We’ve already got someone to replace you, and I just heard back today that he passed his drug test and background check.” Here we are back to respect, and treating people with some basic human decency.

I was shocked. I asked her about my pay, as the pharmacy manager position awards you a $1 per hour increase – she informed me that she would NOT be backdating my pay for the time I had been manager at the pharmacy, because despite the fact that I had power of attorney and was managing the pharmacy, I was not actually the manager there. All of this was completely sprung on me, in a completely tactless and inappropriate way, while I was in the middle of my shift. I felt the entire situation was extremely inappropriate, and I called the district manager. I was told that this was always the plan, despite the fact that one week earlier when she had been in my store, I had mentioned that I heard they had a partner for me, and she had acknowledged that and said she was excited that we were moving in the right direction. She and the interim supervisor had asked me to apply to the internal job posting for the manager position, and even had me spend my personal time writing a resume for the job. There are two options here – they were leading me on, lying to me about their intentions for me, or they lied more recently, informing me that this was always the plan.

Either way, I’m not satisfied with being treated that way. It’s not the decent way to treat anyone, and especially someone who has dedicated their professional life to CVS and volunteered to make personal sacrifices for the betterment of the district.


Now, my career is up in the air, my job in turmoil. No one has bothered to discuss with me what the plan is for my future, where I want to go and what I want to do. My store is in a state of unknown – under my guidance, turnover has stopped and my technicians are once again happy to come to work. We went from running consistently 500-700 scripts past due, to consistently running on time, and even occasionally getting some cleaning and organizing done, despite the fact that we are still understaffed by 60 technician hours a week.

Now, a pharmacist that is new to CVS is being sent in to manage the store. As has been described, throwing unknowns into this store hasn’t been very successful. It’s a tough store. It’s old, small, poorly laid out, and very fast-paced. We have recently grown by about 20% (just in the last few weeks) and have been able to maintain, but the technicians who have been through all of this just a few short months ago are terrified that a new pharmacist will not be able to handle the store and that it will return to how it was. I hope that’s not the case, but to be honest, no one knows.

One interview with someone isn’t going to show you that, and once again we are back to our old management tactics of putting all of our stock in one person to hold it all together. I even volunteered to stay on as the staff pharmacist, feeling that this would bring some stability to the store and that I could be an excellent supporting pharmacist to a new pharmacy manager that is not familiar with CVS’ system and the exact expectations and requirements of the job. This suggestion never even received a response beyond “We’ll talk…” which we never did.


I am not happy to be writing this letter. I had high hopes that a new district manager would bring real change, and that the district would no longer be subjected to the irresponsible and destructive management style that [pharmacy supervisor name] has brought with her.

Despite all of my frustrations, I still struggled with this – my professional career has only ever known CVS. I have made countless friends through this job, in technicians, pharmacists, front store staff, and patients. It’s difficult to walk away. But my hope is lost, my faith is gone. I hope for everyone else’s sake – all of those wonderful people who are still hanging in there, hoping for improvement – that I am wrong and change does come.


Thank you,
Lindsey Hoehn
PharmD