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The worst? Maybe so. But CVS is far from alone.

After a roller coaster of a weekend responding to and reading about Ellen Gabler's NYT pharmacy article, I'm left reflecting that one particular theme seems to have emerged:

CVS is the worst.

While I can't argue against that too strongly, I feel compelled to speak up once more and say:

Yes. CVS might be the worst. But they are far from the only guilty party.

Other pharmacy chains are just as guilty when it comes to heavily pushing metrics and "production" over patient care, and when it comes to treating their employees as if they are less than human.

I know there are incredible economic pressures to cut costs, but the intersection of Pressure and Ethics is no place to make a wrong turn. This is the place where it is incumbent upon any company, corporation, organization, or individual responsible for the health and safety of others to stand firm.

CVS is clearly not doing that. As evidenced by their press release, they claim no wrongdoing. In effect, they call their own employees liars. They defend the exact practices criticized in the NYT article. I understand that in general, companies cannot out-and-out and admit to wrongdoing. But you would think that somewhere, even if it was just the tiniest little nod, they'd commit to re-thinking and improving something about their strategy to "provide care that extends beyond the dispensing of medication."

I find this, and all of their behavior surrounding this issue, both recently and over at least the past decade, utterly detestable. By no means am I giving them a pass, especially since their added control of the industry through their PBM strong-arm has far-reaching and devastating consequences on the entire country and the practice of pharmacy.


All the other companies also called out in that article seem perfectly willing to shrink back and allow CVS to bear the brunt of the glaring, burning spotlight of truth. I haven't heard any response from any of the other chains- maybe it's out there and I just have yet to see it. Or maybe they're just hoping they'll get a free-ish pass while everybody's talking about CVS.

As pharmacists and technicians, we shouldn't let this lull the public into thinking the very same practices don't occur in other pharmacies across the US. Some of those pharmacies are named in the article, others are not. But almost all regularly abuse and gaslight their powerless employees.

Wouldn't you think healthcare professionals, many of whom hold doctorate level educations, would be far from powerless? A closer look reveals that a culture of fear, long-lasting abuse, and financial intimidation (made possible by enormous student loan debt combined with a cutthroat job market for pharmacists, arguably brought about by certain actions of CVS itself and other large chain pharmacies) brings all but the boldest, and perhaps least indebted, into line.

You many have noted that only one pharmacist allowed his opinion to be published in connection with his actual name in the article - a pharmacist who happens to now have a livelihood not dependent on CVS. You may have noticed that the very name of this website contains "anonymous" - the same descriptor also used for every complaint to a Board of Pharmacy that was quoted in the NYT article.

Dissent is deadly to a pharmacist's career. I know from personal experience what it's like to be told by a supervisor, "These pharmacists should get over it. At least they're not working at *insert competitor here*. They ought to just be grateful." This said by a supervisor at a company where pharmacists regularly work upwards of 12 hours at top speed, without breaks - sometimes completely alone - just like pharmacists at numerous other companies across the country.

But somehow in the minds of many corporate supervisors, it's perfectly adequate to just not be "as bad" as the worst offender out there.

My challenge to those pharmacists, technicians, and other healthcare professionals reading this is to comment below your experiences of workplace pressures and abuse at other pharmacies and institutions. I know this is an issue that is not solely unique to pharmacy. I especially encourage you to sign in and comment on this very blog page, with or without your real name. These posts often are shared and discussed on Facebook, which is great itself, but the public readership of this blog does not follow over to my Facebook page for instance and read the comments shared there. I feel those readers deserve to hear from more of us, more easily.

Thanks for reading, and to my colleagues, stay committed. We cannot let this blow over now, once we've finally reached the public, and perhaps, in my wildest dreams, some truly honest and forthright regulators who may see through the smokescreens and lies put forth by giant companies that hold the health of this nation in their hands.

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