Pharmacist and Provider Status

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So a few professors at my school always talk about how pharmacist don't have any provider status with Medicare. Pharmacist are supposely "fighting" to be able to get provider status and paid to do medication therapy, I guess talk to patients about their meds. If they are taking them right, taking the correct dose, and a whole bunch of other stuff. The other day in the classroom, my teacher looked me right in my eyes and told me, "pharmacist don't only sell drugs" LOL I just don't understand how the people that are pushing the marijuana industry to become more like retail are doing it. I'm seeing a lot of advancement going on with the marijuana industry even though the federal law is against it. How is it that a bunch of pharmacist can't change what is going on with provider status? I also don't think doctors like the idea of pharmacist having provider status just a real life observation I made

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Here we go...
I don't understand what you mean by that..... It seems like a legit question: why can't pharmacist change the way things are to get provider status? I think this has been going on since 1965 and the marijuana industry started in 1991 in California and now even Florida (a very conservative state) has it for sale for medicinal use.
 
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Your faculty are either ignorant of history, or bought into the institutional amnesia that pharmacy organizations peddle. This has been answered multiple times on the Boards, but the short story is, HCFA (the forerunner to CMS) openly proposed to the CPT committee that was AMA run at the time to have pharmacy as a provider paid on procedural credits in 1972 to be a part of the initial HMO act. APhA intentionally screwed it up (opposed it officially which is now scrubbed from their institutional history but is readily available at White Oak) being the dysfunctional, counterproductive, and worthless organization that it is today, and there are those in CMS who were in HCFA when APhA did that who aren't inclined to be forgiving to the profession. In other words, there was a time where that was offered to us on a silver platter, but our own leaders tanked that proposition for greed. The most damning thing was when APhA realized how badly they screwed it up in the 1990s, they went to the committee and argued before the very person who advocated for them in the 1970s and tried to lie to his face on the circumstances, not remembering that he was the one who tried to give them that status in the first place, but was derailed because APhA felt that product paid more than procedure. I have it on good authority by multiple witnesses at the meeting that the meeting was abruptly terminated after he lost it in front of them. Ever since, pharmacy talks a game, but does not have any real intention of going through with it. APhA thanks you for getting your Board Certifications to contribute to their warchest.

My own opinion is fairly complicated as to whether or not pharmacists should have provider status, but the main point that I would give is that in a world where pharmacists are paid on procedure and not product, pharmacists should expect to make much less. I've seen clinical pharmacist efficiency, and given a generous 80% of what an FM/IM physician bills for a standard visit through the RBRVU system, pharmacists would have to work pretty hard to break $80k, much less the $130k we are paid now. But, I can't see why a midlevel practitioner couldn't provide those services cheaper (because quality is hard to measure), so I'd be curious about the circumstances. Just as a relatlive matter, our median is still about a third over PA's and about 15-30% over APRNs in most markets for general care (so, I know the CRNA and specialist APRNs make above our level, but they are the exception and not the CVS equivalent). Since pharmacists generally care about their livelihoods, getting a 30-40% paycut might be a bit much to ask.

If there is anything I truly dislike about the profession, it's the mediocrity of us collectively wanting better but not willing to put in the real effort. When we have the rare people who do, they leave the profession as it's easier to change yourself than to change a bunch of shortsighted pharmacists. Someday, I think I'll feel safe enough to surrender my license over ideological reasons as my work no longer requires active practice. But the mediocre pharmacist in me is still too strong in not taking risks, so I still get work to pay for it.
 
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Your faculty are either ignorant of history, or bought into the institutional amnesia that pharmacy organizations peddle. This has been answered multiple times on the Boards, but the short story is, HCFA (the forerunner to CMS) openly proposed to the CPT committee that was AMA run at the time to have pharmacy as a provider paid on procedural credits in 1972 to be a part of the initial HMO act. APhA intentionally screwed it up (opposed it officially which is now scrubbed from their institutional history but is readily available at White Oak) being the dysfunctional, counterproductive, and worthless organization that it is today, and there are those in CMS who were in HCFA when APhA did that who aren't inclined to be forgiving to the profession. In other words, there was a time where that was offered to us on a silver platter, but our own leaders tanked that proposition for greed. The most damning thing was when APhA realized how badly they screwed it up in the 1990s, they went to the committee and argued before the very person who advocated for them in the 1970s and tried to lie to his face on the circumstances, not remembering that he was the one who tried to give them that status in the first place, but was derailed because APhA felt that product paid more than procedure. I have it on good authority by multiple witnesses at the meeting that the meeting was abruptly terminated after he lost it in front of them. Ever since, pharmacy talks a game, but does not have any real intention of going through with it. APhA thanks you for getting your Board Certifications to contribute to their warchest.

My own opinion is fairly complicated as to whether or not pharmacists should have provider status, but the main point that I would give is that in a world where pharmacists are paid on procedure and not product, pharmacists should expect to make much less. I've seen clinical pharmacist efficiency, and given a generous 80% of what an FM/IM physician bills for a standard visit through the RBRVU system, pharmacists would have to work pretty hard to break $80k, much less the $130k we are paid now. But, I can't see why a midlevel practitioner couldn't provide those services cheaper (because quality is hard to measure), so I'd be curious about the circumstances. Just as a relatlive matter, our median is still about a third over PA's and about 15-30% over APRNs in most markets for general care (so, I know the CRNA and specialist APRNs make above our level, but they are the exception and not the CVS equivalent). Since pharmacists generally care about their livelihoods, getting a 30-40% paycut might be a bit much to ask.

If there is anything I truly dislike about the profession, it's the mediocrity of us collectively wanting better but not willing to put in the real effort. When we have the rare people who do, they leave the profession as it's easier to change yourself than to change a bunch of shortsighted pharmacists. Someday, I think I'll feel safe enough to surrender my license over ideological reasons as my work no longer requires active practice. But the mediocre pharmacist in me is still too strong in not taking risks, so I still get work to pay for it.

LOL, I like your respond. I believe professionals should be able to talk about anything openly. I'm very straight forward about what I want to do with my pharmacy degree to my teachers, but sometimes I feel like they are trying to push their agenda onto me. I'm not against or for pharmacists on having provider status, I just do not know much about it yet.
 
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Lord999’s response pretty much summarized it but yes, your professors are drinking the Kool Aid and feeding you a load of crock.
 
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So a few professors at my school always talk about how pharmacist don't have any provider status with Medicare. Pharmacist are supposely "fighting" to be able to get provider status and paid to do medication therapy, I guess talk to patients about their meds. If they are taking them right, taking the correct dose, and a whole bunch of other stuff. The other day in the classroom, my teacher looked me right in my eyes and told me, "pharmacist don't only sell drugs" LOL I just don't understand how the people that are pushing the marijuana industry to become more like retail are doing it. I'm seeing a lot of advancement going on with the marijuana industry even though the federal law is against it. How is it that a bunch of pharmacist can't change what is going on with provider status? I also don't think doctors like the idea of pharmacist having provider status just a real life observation I made
There are three types of professors who teach pharmacy school. PhD who never worked in a pharmacy, MD who never worked in a pharmacy, pharmD who never worked in a pharmacy. Going to pharmacy school then working in retail is like living All Quiet on the Western Front.
 
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If there is anything I truly dislike about the profession, it's the mediocrity of us collectively wanting better but not willing to put in the real effort. When we have the rare people who do, they leave the profession as it's easier to change yourself than to change a bunch of shortsighted pharmacists. Someday, I think I'll feel safe enough to surrender my license over ideological reasons as my work no longer requires active practice. But the mediocre pharmacist in me is still too strong in not taking risks, so I still get work to pay for it.

Agreed, and thanks for posting the unheard history of provider status in pharmacy. I think it's important that students and new practitioners understand what came before them. It provides a level of perspective that you'll never see from your professors (especially the PGY1 trained clinical professor that graduated two years before you).

An especially interesting point is what would be expected of us, and what our compensation would be, should we actually be granted provider status. Too many young and naive pharmacists are salivating at this vague and undefined concept of the "provider" pharmacist. I suppose the starving new grad who is lucky to get part-time work at <$50/hr rates would be more than happy to make $80k/yr, but could the rest of us say the same? I could find pharmacy-adjacent work that pays similarly to my current rate, but it would definitely require more effort than just showing up to the office every day.
 
For pharmacists to receive provider status they'll need to do 2 things
  1. Prove that their services greatly reduce costs to Medicare
  2. Be willing to take less in order to get some of that cost sent back
None of the big organizations have the courage to do both. Not APhA, not NCPA, not ASHP, not any major organization. So it's not going to happen. Provider status on a national scale is probably 40 years away. Pharmacists are too apathetic to really do anything to speed that up and those of us who are active in local and state politics eventually move on to things other than pharmacy because we feel underappreciated.
 
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For pharmacists to receive provider status they'll need to do 2 things
  1. Prove that their services greatly reduce costs to Medicare
  2. Be willing to take less in order to get some of that cost sent back
None of the big organizations have the courage to do both. Not APhA, not NCPA, not ASHP, not any major organization. So it's not going to happen. Provider status on a national scale is probably 40 years away. Pharmacists are too apathetic to really do anything to speed that up and those of us who are active in local and state politics eventually move on to things other than pharmacy because we feel underappreciated.
Not to mention that the AMA is going to lobby against pharmacist provider status because the “role expansion” of pharmacists is only going to come at the expense of MDs. While pharmacists have no actual national organization that lobbies for them, the national organizations for MDs (and RNs for that matter) do actually have a big voice for their profession. Gotta love healthcare politics...
 
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For pharmacists to receive provider status they'll need to do 2 things
  1. Prove that their services greatly reduce costs to Medicare
  2. Be willing to take less in order to get some of that cost sent back
None of the big organizations have the courage to do both. Not APhA, not NCPA, not ASHP, not any major organization. So it's not going to happen. Provider status on a national scale is probably 40 years away. Pharmacists are too apathetic to really do anything to speed that up and those of us who are active in local and state politics eventually move on to things other than pharmacy because we feel underappreciated.

Actually, it's more like:

1. A certain person who was at APhA needs to drop dead. For quite a number of people concerned when he was in leadership, preferably painfully and without dignity. He's apparently working (drinking) on it.

2. Another person who is in CMS right now who hates the pharmacy organizations needs to retire, and I expect him to be carried out of his office as he's already earned the White House American flag retirement and is maxed out in CSRS. He's old enough to have started his tenure in Eisenhower's term (February 1960) in DHEW and considers Trump to be a relatively ok president (couldn't stand Ford, definitely hated JFK, and adores LBJ).

3. What you mentioned above...

4. And hell freezes over, because 3 is just as possible.
 
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Being a recent grad, the things they preach in school are worth less than a compost heap.

In my state, being a "provider" is already possible if you have a consult agreement with the physician. You can do things like taking vitals, talking to the patient, manage drug therapy, call in refills and order labs as appropriate.

Provider status has no meaning if it doesn't bring more lucrative opportunities for the pharmacist. As it stands for now, a pharmacy career is simply a means to an end.
 
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I read all these comments and quite surprised that no one commented on how a registered pharmacy gets paid for when a pharmacist does provide MTM to a patient. It seems to me that the problem is that the pharmacies or physicians are getting paid for it, but not the pharmacist. Either way, it does not effect me, but I don't want to be a POS either.
 
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Being a recent grad, the things they preach in school are worth less than a compost heap.

In my state, being a "provider" is already possible if you have a consult agreement with the physician. You can do things like taking vitals, talking to the patient, manage drug therapy, call in refills and order labs as appropriate.

Provider status has no meaning if it doesn't bring more lucrative opportunities for the pharmacist. As it stands for now, a pharmacy career is simply a means to an end.
I think there might be a possibility for it to bring more lucrative opportunities for pharmacist.
 
Not to mention that the AMA is going to lobby against pharmacist provider status because the “role expansion” of pharmacists is only going to come at the expense of MDs. While pharmacists have no actual national organization that lobbies for them, the national organizations for MDs (and RNs for that matter) do actually have a big voice for their profession. Gotta love healthcare politics...
Yes, my teacher looked directly into my eyes and told me it was because of money and that no one is lobbying for us.
 
Interesting you have an MD that teaches you. What class?

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I had several classes taught by MDs in P2 year-mostly anatomy and physiology courses.
 
Interesting you have an MD that teaches you. What class?

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We had a couple MDs teach oncology and a few others cone in for guest lectures throughout therapeutics

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Does anyone know how much pharmacies actually make from MTM? I know the DM pushes it on us but I still have no idea how much money is actually made. I see that outcomes says they will pay anywhere from like 10-100 dollars but lord knows if its actually collected. Does anyone know?
 
Does anyone know how much pharmacies actually make from MTM? I know the DM pushes it on us but I still have no idea how much money is actually made. I see that outcomes says they will pay anywhere from like 10-100 dollars but lord knows if its actually collected. Does anyone know?

I don't know about everywhere but the one MTM pharmacy that I worked at was payed exactly as described in the case details. That was through Mirixa not Outcomes with payments ranging from $12-$60. The only difference that was in our contract was that we were not paid at all for declined cases even if the case was shown to pay something like $2 for declining.
 
I don't know about everywhere but the one MTM pharmacy that I worked at was payed exactly as described in the case details. That was through Mirixa not Outcomes with payments ranging from $12-$60. The only difference that was in our contract was that we were not paid at all for declined cases even if the case was shown to pay something like $2 for declining.

That seems sustainable to me. Some of the TIPs (I could easily complete 4-5 of these in 10 minutes if they're the easy ones) and CMRs don't take me all that long unless the pt has a ton of questions or something is wrong. One of my colleagues even said that he could make his salary easily if he could just focus on MTMs. Why are some pharmacists against this?
 
Interesting you have an MD that teaches you. What class?

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As other people responded as well, I had several classes that were told by MDs include anatomy and physiology. I also had a class called "clinical skills" in which the MD taught us how to take stats, do basically physical inspection, take history etc
 
That seems sustainable to me. Some of the TIPs (I could easily complete 4-5 of these in 10 minutes if they're the easy ones) and CMRs don't take me all that long unless the pt has a ton of questions or something is wrong. One of my colleagues even said that he could make his salary easily if he could just focus on MTMs. Why are some pharmacists against this?
The main issue I saw was getting the necessary case volume. Assuming you're doing 4-5 tips in 10 minutes, you're looking to bill what, close to 200 tips per day? The pharmacy I was working at had I believe ~60% success rate (lower than most pharmacies because we had a lot of cases given to us that other pharmacies had failed to complete) meaning that you'd easily need over 300 easy tips available to hit that target.

Now CMRs can be quite a bit easier and I was completing most of mine in about 15-20 minutes unless the patient had a bunch of questions or an especially long med list. The issue I ran into there was again getting proper case volume plus the time sink of cold calling people trying to convince them that you were a legit medical professional and not a scam targeting the elderly. I distinctly remember a large portion of my days spending hours making outbound calls just to get 1-2 cases paying ~$60

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The main issue I saw was getting the necessary case volume. Assuming you're doing 4-5 tips in 10 minutes, you're looking to bill what, close to 200 tips per day? The pharmacy I was working at had I believe ~60% success rate (lower than most pharmacies because we had a lot of cases given to us that other pharmacies had failed to complete) meaning that you'd easily need over 300 easy tips available to hit that target.

Now CMRs can be quite a bit easier and I was completing most of mine in about 15-20 minutes unless the patient had a bunch of questions or an especially long med list. The issue I ran into there was again getting proper case volume plus the time sink of cold calling people trying to convince them that you were a legit medical professional and not a scam targeting the elderly. I distinctly remember a large portion of my days spending hours making outbound calls just to get 1-2 cases paying ~$60

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I feel that's very much pharmacy and area specific. At my pharmacy people are typically okay with going through CMRs and TIPs and what not. I did incorporate completing TIPs and CMRs while giving flu shots in our counselling room unless its stupid busy and we have a ton of waiters. Usually its not a problem though, thank God.
 
I feel that's very much pharmacy and area specific. At my pharmacy people are typically okay with going through CMRs and TIPs and what not. I did incorporate completing TIPs and CMRs while giving flu shots in our counselling room unless its stupid busy and we have a ton of waiters. Usually its not a problem though, thank God.

In my experience, patients are much more willing to complete MTMs in these scenarios because you're at the pharmacy that fills their medications and therefore they know and trust you. All of the MTM pharmacies that I'm aware of operate out of what's essentially a call center. It was much more difficult to show that you're acting in the patient's best interests when you're just some person on the phone. Now there were supposedly letters sent out from the patients' insurance carrier letting them know to expect our call but very few patients either got them or paid any attention to them.

All in all, I'm not personally a huge fan of completing MTM services in general and my experience in an MTM pharmacy was certainly worse than my experiences completing them in a "regular" pharmacy. I guess I alluded to my personal issues but they boiled down to:
1) I hate cold-calling people
2) With the number of case declines a significant portion of your day is wasted
3) The volume needed to make up for #2 usually incentivized lower quality MTM so even the completed cases felt like a bit of a waste to me

That said, maybe I just had a bad experience with the company that I worked for. I do know a handful of people that really enjoyed it (though the majority of my coworkers seemed to agree with my sentiments).
 
I know some companies literally have pharmacist who put in time doing just MTMs. Usually, that isn't their full time job and they only do that part of their week, but i was shown the finances and it's easy to justify having a pharmacist on MTMs for some part of their week covering an entire geographical area.
 
Please don't give us the poor retail pharmacists (majority of the pharmacist workforce) more things to do, we deal with enough already.

I remember though, back in my 4th year retail rotation this c0*k sucking pharmacist had me do MTM; it was obviously something he didn't want to do but took credit for it for the metrics.
 
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In my experience, patients are much more willing to complete MTMs in these scenarios because you're at the pharmacy that fills their medications and therefore they know and trust you. All of the MTM pharmacies that I'm aware of operate out of what's essentially a call center. It was much more difficult to show that you're acting in the patient's best interests when you're just some person on the phone. Now there were supposedly letters sent out from the patients' insurance carrier letting them know to expect our call but very few patients either got them or paid any attention to them.

All in all, I'm not personally a huge fan of completing MTM services in general and my experience in an MTM pharmacy was certainly worse than my experiences completing them in a "regular" pharmacy. I guess I alluded to my personal issues but they boiled down to:
1) I hate cold-calling people
2) With the number of case declines a significant portion of your day is wasted
3) The volume needed to make up for #2 usually incentivized lower quality MTM so even the completed cases felt like a bit of a waste to me

That said, maybe I just had a bad experience with the company that I worked for. I do know a handful of people that really enjoyed it (though the majority of my coworkers seemed to agree with my sentiments).

I can understand why you didn't enjoy your time there. Even though I am a pharmacist, I wouldn't feel comfortable with a random person calling me doing MTM over the pharmacists at the pharmacy I fill at. It makes me wonder why they don't just station these pharmacists at pharmacies. It would make patients more comfortable plus it would open jobs up in the community setting.
 
^$$. Why have one person at each store when you can have one person oversee multiple stores from a call center.
 
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It makes me wonder why they don't just station these pharmacists at pharmacies.

Like projektreverb said, I'm sure it's all about money. Why pay another pharmacist to do that when they can just add it to the current pharmacists' workload?
 
Like projektreverb said, I'm sure it's all about money. Why pay another pharmacist to do that when they can just add it to the current pharmacists' workload?

MTM's would be way more successful, at least theoretically, from a regular pharmacy than from a call center. You have to pay a pharmacist's salary either way, so why not put them in a position to be as successful as possible (read bill more)? Maybe I'm just too hopeful lol
 
There are three types of professors who teach pharmacy school. PhD who never worked in a pharmacy, MD who never worked in a pharmacy, pharmD who never worked in a pharmacy. Going to pharmacy school then working in retail is like living All Quiet on the Western Front.

This statement about PharmD professors that never worked in a pharmacy does not seem true to me. There is a fourth type and a fifth type.

Fourth type: Most faculty I know have interned at hospitals and in retail during pharmacy school, usually 1-3 years, before they were "lucky" enough to attain PGY1/PGY2 training. Some professors have pharmacist (not intern) experience before accepting the professor position. I know 2 who got their PGY2s later on in life. I cannot argue that you do have professors that go straight into academia without working as a pharmacist first (outside of residency training), which creates conflict with those who have been dosing medications for years. Those that work as a pharmacist first, in my opinion, have better credibility than someone straight out of residency. I would favor and network with those people first.

Fifth type: Worked for many years as a retail pharmacist, then earned a fellowship in an area that suited them. The fellowship and published papers got them the faculty position: the fellowship was in Women's Health through NIH. It took 10 years, but the professor still got the position.

I am not exactly sure where this erroneous thought of all professors not working as pharmacists is coming from. If anything, working in a pharmacy after a PGY1 enhances their credibility and makes them more able to teach their students. I would prefer those people with experience over someone straight out of residency. Having that experience means those people have a clue about what they want in their careers and are not pursuing a residency for the wrong reasons.

Just a tidbit: we had a pharmacist from the NAVY with 25+ years experience teaching our leadership series of lectures for pharmacy school: he had NO RESIDENCY but provided tremendous insight into pharmacy operations and leadership. As students we petitioned for him to become a full-fledged faculty member in 2016, but apparently our school (USFCOP in FL) felt otherwise. Politics runs the show, not quality, especially in pharmacy school. I agree that we are being taught what is needed to attain the degree, but the degree with experience should be enough for most positions without further post-graduate training. Why make the education of pharmacists more complicated (alluding to PGY3 thread)?

I am not residency trained, so I cannot "drink the Kool-Aid," so to speak, especially if it is a bland, uninteresting flavor (metaphorically speaking). I think residency is grape-flavored Kool-Aid, which can be either sweet or tart depending on who tastes it. "Grape-flavored, go figure."

Unless a residency the only way to attain an academic position, which it is not, I see no point in buying into the scam of residency unless the skills and credentialing offer a better job with the paycut: from a salary of about $110K on average to about a $40K-45K PGY2. Most of the pharmacists I worked with felt the same way both on P3 and P4 rotations and while working as a Pharmacy Technician before pharmacy school.
 
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Here we go...

Lol!!

Anyway - the real answer to this question is... money

It’s all about who is lobbying these laws with the most money. The docs lobby against us and they have waaaaay more money than we do.
 
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As other people responded as well, I had several classes that were told by MDs include anatomy and physiology. I also had a class called "clinical skills" in which the MD taught us how to take stats, do basically physical inspection, take history etc
All which are not within your scope of practice as a pharmacist. especially respiratory exam and cardiology exam. That should be banned from the curriculum of pharmacy because that is appropriate for a MD.
 
Did you know the marijuana industry made more money than taco bell last year and is on track to top the NFL this year? Thats where i am trying to get into. Forget this traditional pharmacy thing, the future is changing rapidly and you can clearly see our profession is dead. So give it a go, be an owner and run a shop, or be a grower/supplier, make your own line of tinctures, edibles, or whatever.....i mean jeez, we can compound!! it's fairly easy to make ALL this stuff....laminar flow hood, licensed facilities, sterile compounding.....easy peasy. How about a sleep line including CBD/Valerian/Melatonin? throw in some chamomile or whatever ya know? good for the digestion....people eat this stuff up literally, a BILLION dollar industry. Do you know hohw much money you can make with HEMP SOAP? my buddy owns a head shop in florida and his girl started a line of hemp soap. started small, now she gets orders for thousands of bars at a time....happened quick too. They had to quickly find a more industrial setting to make it as the home was too little! no kidding, they make a fortune...We have options, dont feel trapped.
 
If it doesnt come with a massive pay increase...i dont want it. Its just another shot to give or some other hassle.
 
If it doesnt come with a massive pay increase...i dont want it. Its just another shot to give or some other hassle.

Wait what? I'm talking about opening your OWN THING.... ya know? you may never be a million aire, but what if you could make a good living money wise ( comparable to pharmacy or better) and have more peace of mind? And who knows with business, you could end up shooting for the moon and hitting the stars.....end up a million aire.....or you can stay stuck in a hamster cage all day hoping they dont bring you out back and shoot you in the head.....while you slowly lose your mind....lol
 
So a few professors at my school always talk about how pharmacist don't have any provider status with Medicare. Pharmacist are supposely "fighting" to be able to get provider status and paid to do medication therapy, I guess talk to patients about their meds. If they are taking them right, taking the correct dose, and a whole bunch of other stuff. The other day in the classroom, my teacher looked me right in my eyes and told me, "pharmacist don't only sell drugs" LOL I just don't understand how the people that are pushing the marijuana industry to become more like retail are doing it. I'm seeing a lot of advancement going on with the marijuana industry even though the federal law is against it. How is it that a bunch of pharmacist can't change what is going on with provider status? I also don't think doctors like the idea of pharmacist having provider status just a real life observation I made

The medical system cannot afford to pay a whole country of pharmacists......we would all drop out and open up private practices doing MTM, Coumadin/INR monitoring.....whatever right? and the insurance companies would go broke. lol. There are literally 15,000 graduating just this year!! imagine if we all started billing for our time and services? yeah never happen....
 
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The medical system cannot afford to pay a whole country of pharmacists......we would all drop out and open up private practices doing MTM, Coumadin/INR monitoring.....whatever right? and the insurance companies would go broke. lol. There are literally 15,000 graduating just this year!! imagine if we all started billing for our time and services? yeah never happen....
Pretty sure I'll happily stay at my hospital job...
 
Pretty sure I'll happily stay at my hospital job...

If we suddenly had provider status, why would you NOT work for YOURSELF? you typically get nowhere working FOR other people. Standard rule in America. ya just get by......
 
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