This would qualify for quote of the month, except that the comment was made during the last week of February. In any event, during a conference call with Wall Street analysts, Express Scripts ceo George Paz let it be known just how valuable pharmacists really are. In response to a question about narrow networks of pharmacies, he had this to say...
"At the end of day, as I said earlier, Nexium is Nexium, Lipitor is Lipitor, drugs are drugs and it shouldn't matter that much who's counting to 30," George said. "...we believe that the community pharmacists serve a very important role in healthcare, that they do a tremendous amount. But we just don't see that one pharmacist does it that much better than another pharmacist, at least not by change (sic)" (here is the transcript).
Of course, some context helps. Express Scripts, which hopes to receive regulatory approval for its proposed $29 billion acquisition of Medco Health Solutions (see this), had been locked in a heated dispute with Walgreen and, as a result, the drug-store chain is no longer in the network run by the pharmacy benefit manager.
So far, Walgreen has taken a shellacking (look here). And Paz used the opportunity to, essentially, say that pharmacists are interchangeable. This will certainly not endear him to independent community pharmacies, who are lobbying strenuously against approval of the deal to buy Medco. But he is unlikely to care.
More to the point, Paz is correct to say that any pharmacist should be able to count pills correctly, regardless of which counter they stand behind. But he may not have realized how this might sound to his own pharmacists, who toil behind the scenes at the Express Scripts mail-order operation, jawboning with doctors, insurers and patients, and ensuring prescriptions are handled correctly.
This gaffe, however unintended, is reminiscent of recent remarks by Sanofi ceo Chris Viehbacher, who did little to inspire his scientists when he commented that the best researchers want to work at biotechs and that big pharma does not know how to innovate. The statements set off a furious debate about big pharma, innnovation and ceo leadership (see this).
To that end, Paz may have walked down the same treacherous path. In the interest of telling it like it is, employee morale can take a beating and the mantle of leadership can suffer. For the moment, though, Paz is more likely to be concerned with the Medco deal. And Walgreens may not be in a rush to hire. But some Express Scripts pharmacists may wonder about their value. After all, if they can count, then they can probably do that math, too.
23 Comments
May I observe tnat, based upon recent North NJ news, the ones who can't count "go to [competitor name redacted]?" (As referenced on this site last month)
That said, Mr Paz is a prime example of 'CEO hoof in mouth' - perhaps a stint on 'Undercover Boss' would do him good?
All I can say is: What a jackass.
Does Paz think those 4 postgraduate years of pharmacy school are just a scam that has been propagating for hundreds of years???
Thanks to punks like him, pharmacists spend too much time explaining people's own insurance to them instead of counting to 30.
Sure anyone can count pills. It takes a real pharmacist to make an old fashioned Bronx Egg Cream or a Root beer Float (A&W only, please).
Another CEO with no clue who actually does the work for him so he can get his million(s)dollar salary. All these guys just want to line their own pockets with more money.
Once they have 60% of the market (Express + Medco) they can play hard ball with anyone they want and shut out more pharmacies.
Maybe George Paz would also apply such simplistic thinking to other professions:
--being a psychiatrist is easy: anyone can listen to psychobabble and reply with psychobabble in return
--Being a dermatologist is easy: when someone comes in with a rash: if its wet, dry it if its dry, wet it
--Being a PhD drug research scientist is easy: anyone can mix liquid "A" with liquid "B"
--Being a primary care physician is easy: anyone can prescribe a z-pack to someone with an infection
--Being an anesthesiologist is easy: anyone can put someone to sleep
etc, etc...
OIIIAI, You forgot my favorite: Any surgeon can operate drunk; it takes a great surgeon to operate with a hangover.
BTW, with the derms you forgot to mention use plenty of steroids.
Being a chocoholic my favorite pharmacist concoction was "burn one all the way".
Here's the patron saint of the soda jerk pharmacist:
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/11/19/BAGFSMFU5A1.DTL
Don't forget that Express Scripts, in its purchase of Medco, has inherited Medco's support and its naming of the Medco/Fairleigh Dickinson School of Pharmacy in Madison, NJ. What does Paz's statement say to potential applicants? Has to be a nightmare for the Medco/FDU administration. Do they want an Express Scripts name on their school....probably tempts them to return the $5 million gift.
Two thirds of every doctor visits results in a prescription. Half of all prescriptions are misused. 1.5 million preventable adverse drug events occur every year. Tens of thousands of people die every year from unintentional prescription drug overdoses. 96% of people don't ask questions about how to properly use their medications.
http://www.ismp.org/pressroom/viewpoints/CommunityPharmacy.pdf
Do we really want people with less of an opportunity or spending less time talking with a pharmacist? This guy is a jerk and shouldn't be running a healthcare company-he'd fit in great on Wall St. Patient safety is paramount.
Really? Anyone can count pills? I've been going to the same independent pharmacy for 30 years. Last month I brought in a prescription for 60 tablets. After picking up the filled script and coming home, I opened the package -- only to find a too-small bottle to accommodate 60 of these tablets. I poured the pills out onto a paper napkin and began to count. There were 30. In fact, 60 could never have fit into that bottle.
Usually, when this 100+ - year-old pharmacy, one of the best in NYC, is short on a script, they tell me when I pick it up, or call me before I go in. For 29 years, this was without exception. This time, no call and no indication in the bag that they did not have the full amount of the drug and owed it to me.
Had the pharmacist miscounted? There was no note in the file that they owed me pills. I had to convince the pharmacist that I didn't pull out 30 tablets before I brought in the bottle. I said to him, "Show me how 60 could how 60 tablets could have fit into this bottle?"
There's no room for human error. A friend of mine recently picked up a script from a local chain pharmacy, only to find out when she got home that it was the wrong drug...one that could have killed her! The lesson: Check every bottle before you leave the pharmacy, and only have drugs delivered when it's absolutely necessary.
@ Randi,
Do pharmacists make mistakes? Absolutely. They are usually a bit more visible than physician mistakes like misdiagnosis or sewing someone up with a sponge inside.
If you want to get an idea of how severe/common pharmacist mistakes are the last professional liablilty insurance that I had was about $175 per year about 5 years ago. What do docs pay?
What a tool. I hope he's going to SF next month to AMCP so I can "accidentally" spill my drink on him!
Just read the entire investor session - if we think the merger between Medco and Wellpoint is going to improve patient health care - we are delusional. George has clearly one thing on his mind - $$$$$$. At least he is transparent as to his goal with the merger - cut costs. And as long as he thinks pharmacists are interchangeable and a little more skilled than a trained monkey, you an bet that he will begin the process of using more techs and changing the pharmacy laws that protect patients. If this merger goes through - he WILL be unstoppable. All pharmacists - regardless of their place of employment - should be expressing their concerns to their congressmen.
By his logic,
Being a CEO is easy: anyone can screw over their employees, make decisions that line their own pockets, compromise the health of those who purchase their product / service, and generally uphold an image of doing nothing more than collecting big cheques from their stakeholders.
Begin the slow clap now...
Forgot to mention the all important: "be a general douche."
Oh, and wear expensive clothes, smoke expensive cigars and drink expensive liquor.
If I were George Paz, I would be taking a close look at the pills in my next dispense. I would also be down on my knees praying that I and no one close to me is diagnosed with colon cancer and needs (counterfeit) Avastin in the next few months.
Here you go....maybe George Paz can blame the comment on his pharmacist and physician:
http://www.medscape.com/viewarticle/458867
Abstract
Objective: To review case reports of statin-associated memory loss as well as the available published evidence for and against such a link. Methods: We searched the MedWatch drug surveillance system of the Food and Drug Administration (FDA) from November 1997-February 2002 for reports of statin-associated memory loss. We also reviewed the published literature (using MEDLINE) and prescribing information for these drugs.
Results: Of the 60 patients identified who had memory loss associated with statins, 36 received simvastatin, 23 atorvastatin, and 1 pravastatin. About 50% of the patients noted cognitive adverse effects within 2 months of therapy. Fourteen (56%) of 25 patients noted improvement when the statin was discontinued. Memory loss recurred in four patients who were rechallenged with the drug. None of the 60 reported cognitive test results. Two placebo-controlled trials found no benefits for statins on cognition or disability. One randomized controlled trial of simvastatin found no effects on cerebrospinal amyloid levels. In one small, randomized study, patients receiving statins showed a trend toward lower cognitive performance than those receiving placebo. Five observational studies found a lower risk of dementia among patients receiving statins. Conclusion: Current literature is conflicting with regard to the effects of statins on memory loss. Experimental studies support links between cholesterol intake and amyloid synthesis; observational studies indicate that patients receiving statins have a reduced risk of dementia. However, available prospective studies show no cognitive or antiamyloid benefits for any statin. In addition, case reports raise the possibility that statins, in rare cases, may be associated with cognitive impairment, though causality is not certain.
Hey Pharmacist, Donald Fagen is requesting a Black Cow:
http://www.youtube.com/watch?v=fY_FI9J1poQ
Being a pharmaciist has to study and work hard, being a jack ass CEO like Paz is just to collect big fat checks, lay off many pharmacist in PA and jerk talking; I do not think we have any CEO in the world to match this record as Mr. Jack-ass-paz!!!
Your organization is totally ridiculous. My dr sent several scripts and I have been receiving letters and phone calls days apart about each script! It is insane and takes much much too long and far too much aggravation."we have received your order" times 4. "we are preparing your order"x 4. Days go by." hello, we will be sending your order in a couple of days" hello,hello, is this Patricia. Patricia we are sending your order tomorrow". Adinfinitum!,!!!!. Saving money is not worth the bizarre nature of your operation. Are you there Paz. I am 80 years old and never experienced such a stupid, idiotic business in my life. 8 -6 more stupid garbage below.
We spoke with your rep last week and told them that since your company had implemented a process of charging extreme amounts for Brand Drugs my In laws would no longer be able to afford the copay and as such we have listed that all drugs should be generic.tonight we found that your company has sent 2 orders to my inlaws, 1 being generic with standard coapy and one being brand and charging them over $400 dolars co-pay.... This is not acceptable, just to make sure that your share holders can make more profit.
Since my father in law worked for your drug company and retired he has slowly been treated worse and worse, your company should be ashamed at their actions and should look at what the real purpose of health care is about. I am so angry about the way you and your company treats these people who made this country great you should be ashamed