Sterile compounding optimization during COVID-19

From January 2020 until March of 2022, I was one of two inpatient pharmacy supervisors at Community Regional Medical Center (CRMC) in Fresno, California. CRMC is a big level one trauma center. They have about every imaginable service, minus only bone marrow and solid-organ transplants. The pharmacy is large and busy. The size and complexity … Read more

25 Years a Failed Career 

I recently took a job as the Director of Pharmacy for a medium sized – just over 400 beds – acute care hospital a couple of hours away from my home in Fresno. I never wanted to be a director. I always told myself that if I ended up working in a pharmacy, it was because … Read more

Remdesivir, the pharmacy budget buster

I saw the discussion below in one of the pharmacy forums. Fact check true on this one. Gilead would have everyone believe that remdesivir is a magic bullet for COVID-19 infection. Not true. Helpful? Useful tool? Maybe. Remdesivir, while potentially beneficial, has limitations. For one, it should only be used on hospitalized patients that have … Read more

The impact of COVID-19 on Pharmacy Personal Protective Equipment (PPE)

COVID-19 has taught us many things, among them that our healthcare supply chain is poorly designed and flimsy. Just a few weeks into the pandemic and our supply chain for Personal Protective Equipment (PPE) has been completely disrupted. PPE is now in short supply, and I suspect that we will run out of PPE in … Read more

Pharmacy Integration is Starting to Make Sense

I’ve been writing about the need for pharmacy integration for years. Most of it negative, and deservedly so because it’s been lousy. With that said, things appear to have changed in recent years. Integration, it seems, has slowly become a thing. Maybe because I’ve been out of general pharmacy practice for so long that it … Read more

Today’s sterile compounding climate is a lesson on availability cascades

I’ve been slowly reading ‘Thinking, Fast and Slow’, a best-selling book by Daniel Kahneman, a Nobel Prize winning psychologist and economist known for his work on the psychology of judgment and decision-making.  The book summarizes behavioral science research conducted by Kahneman. The recurring theme of the book is what the author defines as two modes … Read more

Chapter 8: First things first

Several years ago, shortly after I was let go from Talyst, I found myself with some free time on my hands. I started writing a book. The book was titled ‘Making the right choice: Helping pharmacies make smart decisions about automation and technology’. Like many books I’ve started, it remains unfinished. I don’t think I’ve … Read more

Disruptive technologies in pharmacy, reality or myth?

There was an interesting thread in one of the ASHP practice forums recently. Someone asked whether or not pharmacists were “ready for the future that the opportunities these disruptive technologies offer”. This in reference to technologies that they saw in the exhibit hall at ASHP Midyear. The simple answer is no. Pharmacists are barely ready … Read more