Raj Bhat RPh My Hunger Strike v Medco

Letters from Raj Bhat

2010-10-28T08:45:00.002-04:00

Readers: Would you like to read letters sent by Raj Bhat asking for answers and attention to Quota System problem at Medco? Click on the headlines below to read more. Also, see "My Final Message" Tab for more.

Raj Bhat Letter to US Senate Finance Committee

Raj Bhat Letter to US Justice Department, Criminal Division

Raj Bhat Letter to Jim Cramer, CNBC - Mad Money

Raj Bhat Letter to Ravi Sachdev - Deutsche Bank

Letter from Raj Bhat RPh to Leo Gerard, United Steelworkers Union President. 10-13-2010

2010-10-18T18:27:00.002-04:00

To: Mr. Leo Gerard, President, United Steelworkers Union

Five Gateway Center, Pittsburg PA 15222

From: Rajendra M. Bhat RPh, Tampa FL

Date: October 13, 2010

Via: Express Mail

Dear Mr. Gerard:

This has reference to your letter dated July 30, 2010 (click here) and my response letter to you dated August 6, 2010 (click here).

In your letter dated July 30, 2010, you had mentioned that you are also fighting to be free from corporate speed -ups, which you recognize endanger the workers and professionals as well as the public. You had assured me that you were raising this issue with Medco Health Solutions in bargaining so that we can help create a more humane and safe workplace and ensure consumer safety.

You had also asserted that you were already advocating on behalf of pharmacists at Medco on this very issue, in the Indianapolis Star article (click here). In that article your Union had mentioned that Medco makes high demands on its professional workers (technicians and pharmacists) to work at too fast a pace and termed it as UNREASONABLE PRODUCTION REQUIREMENTS.

That article also asserts that Medco’s own employees have said that Medco pushes the limits. Your Union spokesperson, Ms. Maria Somma has also mentioned in that article "If a pharmacist can't read or decipher or understand the prescription, they will have to call the Doctor’s office to get to the bottom of it, that takes longer and the Company does not like it”.

It is very evident from Ms. Somma’s quote that Medco wants to reduce costs by pressuring pharmacists (not to clarify unclear prescriptions) to squeeze in more profits at the expense of patient health and safety.

In a subsequent audio interview with National Public Radio (WMNF.org) (click here) in September 2010, your Union Vice President Mr. Fred Redmond had admitted to these unreasonable production demands, which he has mentioned as concerns “only at the New Jersey facility.”

I was surprised at his audio quote, which mentions "He had discussions with Medco Pharmacists in Tampa and had discussions with Medco and that there seems to be a consensus that work they do in Tampa does not put the public at direct jeopardy.”

This statement is totally misleading to say the least.

I would like to bring to the attention of Mr. Redmond that the Indianapolis Star article (click here) had also researched this issue. It mentioned that in 2003, more than 40 pharmacists in Tampa signed a letter and sent it to the Florida Department of Health protesting the Company's demands to speed up their work to a pace of less than two minutes per prescription, even if the prescription was illegible or incomplete.

That article had also quoted the Tampa pharmacists “The unrelenting pressure and threat of disciplinary action in relation to ever-increasing rates and professional judgment issues has created a situation which puts patient health at grave risk".

I am enclosing herewith the copy of that letter from Medco Pharmacists from Tampa for your immediate reference (click here).

I understand that Medco around 2007, transferred prescription entry and checking tasks by Pharmacists from Tampa to New Jersey and other facilities and to work-at-home pharmacists.

I would also like to bring Mr. Redmond's attention to the fact that Pharmacy Technicians at Tampa are still entering prescriptions at the Tampa facility and they are pressured to reach the target of up to 70 prescriptions per hour by the end of this year (2010).

It is stunning to me that you all are not paying attention to these facts.

What comes to my mind is the Bridgestone – Firestone Fiasco. The Employees were forced to cut comers and conduct Quality Specification checks at increasingly higher and unsafe rates per hour, to squeeze in more profits for the Company. The employees for fear of retaliation and losing their jobs co-operated with the Management in the implementation of these unsafe practices. As a result, the quality checks could not be completed accurately in the short span of time the employees were given to focus on the job at hand. This resulted in faulty defective tires passing the quality specifications checks, which were later distributed for widespread public use. Bursting of these tires left, right and center, led to so many lost lives of innocent people.

In your letter dated July 30, 2010 (click here), you had urged me to stop the fast and "trust in the collective power of the union to help solve this issue.” In my response letter to you dated August 6, 2010 (click here), I had assured you that I would stop this fast promptly if you translated your words into action.

In that letter, I requested you to negotiate with Medco and its Board of Directors to stop these wrongful practices; bring this matter to the attention of the public via national press; apprise the US Justice Department of the criminality of these practices; make yourselves available for US Senate Finance Committee hearings, and take appropriate actions to undo the damage caused to me by Medco.

You have not responded to my letter, though more than 2 months have passed by.

I understand that you have met Medco CEO, Mr. David Snow in the month of September 2010, in relation to this issue.

We have contacted your office and have still not gotten any definitive answers from you or the Union spokesperson.

Once again, I would like to emphasize here that for me the value of lives of innocent patients who can get hurt or killed (which includes children though I personally do not know them) is equally important in comparison to my own life, and lives of my family members. Every single day that goes by, more such innocent lives of Medco patients are put in jeopardy.

I once again request you to communicate with me and let me and the public at large know about the details of your last meeting with Mr. David Snow, and how you are translating your assurances in the form of words into concrete actions to safeguard patient health and safety.

During the last month, I have seen you on MSNBC, talking about Workers' Rights and your criticism of the American Chamber of Commerce in its role of shipping American jobs overseas and its role in contributing to American elections via overseas funds.

It sounds ironic, to say the least, that you are not taking any concrete corrective actions in relation to an American company you oversee and stop its wrongful unsafe practices, that you yourselves have admitted jeopardizes patient health and safety here in the US.

Is this talk all just rhetoric on National TV and nothing more?

At this point in time, though I feel spiritually strong and at ease with my spirit and soul, I am uncertain as to how long my body will hold up, now that my hunger strike has gone past 100 days.

In the midst of this uncertainty, at least you owe me a definitive answer one way or the other. Your continuing silence and inaction to stop these practices invigorates my intent many folds to continue this fast indefinitely, till my last breath wherever it leads me to.

I take this opportunity to thank you for your time and attention.

Expecting to hearing from you soon,

Sincerely,

Rajendra Bhat RPh

Enclosures:

1. Copy of July 2010 Indianapolis Star article

2. Your letter dated July 30, 2010 addressed to me

3. Copy of the letter dated July 17, 2003 signed by more than 40 Medco pharmacists (Tampa facility) addressed to Florida Department of Health.

MY FINAL MESSAGE

2010-10-04T22:18:00.000-04:00

People have asked me why I am still continuing this hunger strike in peril of losing my own life.

Some have termed my fight as nutty, crazy etc.

I would like to express my thought process and my mind set on these issues.

Medco Health Solutions NYSE: MHS (Medco) pharmacy’s Dangerous business practices are indefensible by any standard of yardstick (legal, ethical and moral). During the past 7 years or so (since 2003), I have fought this issue patiently in every other way without putting my life in harm’s way. I urge the readers to review the facts I have presented in this regard please see "JUSTICE DELAYED IS JUSTICE DENIED".

Why a Hunger Strike?

Because of the continuing threat to the health and safety of Medco’s patients, and justice being constantly delayed, denied and not even visible for years in the future, I had decided to take this matter directly to the Court of Public Opinion, by starting this Indefinite Fasting\ Hunger Strike on July 5, 2010.

This hunger strike was not an impulsive decision. I had given a great deal of thought before I started this fast. People have asked me questions like ... why a hunger strike? What is the logic of subjecting one's own life to harm’s way? Why continue this fast indefinitely, now 92 days and counting. Do you intend to kill yourself by continuing this fast? etc.

My Fight for the Practice of Pharmacy

I would like to explain in detail here the moral compass of this issue and my mind set to continue this fast. This is my fight on behalf of all the Pharmacists to safeguard the Practice of Pharmacy and our obligation to practice Pharmacy safely in the interests of vulnerable Patients at large. This is also my fight to safeguard the rights of the Whistleblowers who show the courage to complain to the Regulatory Authorities in the interest of Public Health and Safety. This is also my fight on behalf of all the families of whistle blowers who are placed in difficult situations and hardships for years attributed to Regulators and Legislators not doing their jobs for which they are hired.

A Widespread Appeal

By observing this fast in a peaceful and non-violent manner I have been appealing to the conscience of the American people at large, United Steelworkers Union, Public Interest Advocacy Groups, members of the Legal Profession, Legislature, Rating Agencies like JCAHO(Joint Commission), Regulatory Agencies, Board of Pharmacy, US Senate Finance Committee, Medco’s CEO, the Medco Board of Directors, the Medco shareholders, Florida Pharmacy Association, American Pharmacists Association and the members of the press.

This has also been my appeal to the conscience of Legislators and Lobbyists who knowingly do corporate bidding and compromise Public Interest and Safety. I have written to most of these Institutions (in one form or the other) before and after I had started this fast. All these communications will be placed on my blog at www.ihungerstrike.blogspot.com for the benefit of the readers.

Christian or Otherwise

I am not a Religious scholar. Hence, I ask my readers to correct me if I am wrong in my expressions of theology of religious pronouncements herein. Just going by the demographic majority, I believe that the majority of these Regulators, Union Officials, the Medco CEO Mr. David Snow and other Medco officials, Attorneys who represent Medco, and, Legislators in positions of power, are Christians of one denomination or the other and that they believe that JESUS DIED FOR THE SINS OF HIS FELLOW MEN.

Maybe they go to church to pray to Jesus to bestow on them all the material comforts, (even at the cost of embracing or participating in deceitful actions). Maybe, they pray to Jesus to give them smartness and intelligence to commit crimes against Society of which they are a part and ultimately represent. Maybe, they do not pray to Jesus to give them strength and wisdom to do the right thing for which they are hired by Society. Maybe, they think Jesus will get reborn and die again to rid them of their sins. It is fascinating to listen to ongoing debates about personal salvation and collective salvation for Society, the role of the Ten Commandments and social justice etc. Though I am not a Christian by religion, I highly regard the spiritual wisdom and values that emanate from the life of Jesus Christ and the principles of non-violence he symbolizes.

What is really intriguing to me ... strictly viewed from a material plane from Medco's point of view is that its Pharmacy Practice is not even a smart way to run the business. Sweeping the dirt below the carpet and pretending to themselves and to the public how honorable their business practices are does not make any business sense by any standard of yardstick. Sooner or later dirt under the carpet is going to stink.

Another Preventable Disaster, For Example

What comes to my mind is the Bridgestone - Firestone Fiasco. The employees were forced to cut corners and conduct Quality Specifications checks at increasingly higher and unsafe rates per hour, to squeeze in more profits for the Company. The employees for fear of retaliation and losing their jobs co-operated with the Management in the implementation of these unsafe practices. As a result, the quality checks could not be completed accurately in the short span of time the employees were given to focus on the job at hand. This resulted in faulty defective tires passing the Quality Specifications checks, which were later distributed for widespread public use. Bursting of these defective tires left, right and center, led to so many lost lives of innocent people.

Some people have expressed to me that if I did not like the way a company like Medco operated, I should have left voluntarily and there should not be any moral dilemma. If I were to work in a profession that does not have to deal with public safety, (like a Home Improvement Store, Grocery Store) I would have walked away if I did not like the way they conducted the business. In those kinds of circumstances, there would have been no moral dilemma for me.

What I Believe

I am a Hindu by Religion. I am not a religious person in conventional terms. I know it will be a bad Karma (actions) and I will have to pay for the consequence of my actions in front of the Almighty force if I let down millions of these innocent patients and walk away from the bad Medco Pharmacy Practice for my own comfortable life for my family and me.

According to my understanding of the purpose of life, this life is an opportunity to exercise our thinking capacity as human beings via our conscience to do the right actions (Karma) both in our personal and professional lives, especially when placed at difficult crossroads at various phases of life.

I also believe, we have control only over our own actions (right or wrong) and have no right over fruits or consequences of our actions. I believe based on the right or wrong actions we do during the course of our life, we will carry with us an enhanced or diminished soul when we die in comparison to the soul force we came into this life with when we were born.

I also believe bad Karma not only affects the personal soul of the individual in question, but also the collective souls of his/her family members in good or in bad ways as the case may be. This concept is somewhat analogous to collective salvation for good actions and cumulative collective peril for bad actions, as pronounced in the Christian faith.

Don’t Do It?

Some of my well-wishers who are concerned about my health have advised me that my commitments towards my family should take precedence over Medco, a rogue company that is attempting to get away with business crimes using its enormous resources.

With the same kind of presumptuous material logic, companies like Medco think that a whistleblower in my position or any of their regular Medco Pharmacists will not dare to take up this fight. In fact, Medco attorneys did try to subtly intimidate me from pursuing my legal fight citing to me the same as a deterrent.

On the face of it, on a material plane, some people might stand in judgment that by resorting to this moral fight I am abandoning the interests of my family. I strongly believe in the opposite. In the spiritual terms, I know I am protecting my family from consequences of a potential bad Karma if I were to abandon millions of innocent patients for our own material comfort and turn a blind eye to Medco’s bad business practices. Hence, my family is supporting me strongly in this fight. They are all spiritually strong and handling this with a great degree of calm, composure and inner strength.

A Few Comments about Corporate America

I would like to emphasize here that I am a strong proponent of American Capitalism directed towards achievement of both individual and corporate well being and prosperity.

There are so many Good Corporations who exhibit Good Corporate Citizenry and believe in doing the right thing. In reality, they exercise their responsibilities and obligations to the work force, the customers and society in a lofty and commendable manner. In such instances, there is no necessity for a watchdog group or an organized union to hold them accountable for public health and safety transgressions.

On the other hand, there are some Corporations like Medco, who exhibit Bad Corporate Citizenry and have a total disregard for public safety and health. The unfortunate part of all this is... when a Company like Medco is allowed to get away with these criminal acts, other rogue companies in this competitive health care industry follow suit. This will undoubtedly cause irreparable damage to the practice of Pharmacy profession, the next generation of pharmacists, and the patients at large; it will also leave the whole system in shambles.

I highly appreciate and understand the concerns expressed for my health and the welfare of my family, but

THE CAUSE OF MY FIGHT IS BIGGER AND MORE IMPORTANT THAN ME AND OUR FAMILY INTERESTS.

I believe I have done enough to safeguard my family interests to the best of my ability, human limitations of circumstances and my conscience.

Go to the Doctor?

Some have also suggested to me that I should go to a Doctor and get his approval to further carry on this fight. When a soldier takes up his job, he and his family know anything can happen. However, he should battle with his focus on the task at hand. When in harm’s way, fearing consequences, he cannot carry on his fight wanting or expecting the Doctor to approve his situation. In any case, no Doctor would give his approval to continue to deprive oneself of food for days at a stretch.

The Purpose of this Hunger Strike

I would like to emphasize here that I did not start this fast to die for this cause. I started this fight to awaken public awareness to this issue and hold Medco accountable.

My goals have been to continue this fast until Medco agrees to stop these UNSAFE & DANGEROUS Business Practices and take responsibility for them.

What that means is...

1. Medco should allow Pharmacists enough time to completely and accurately check prescriptions according to the requirements of its own Standard Operations Procedure (SOP).

2. Medco should stop penalizing and disciplining Pharmacists for exercising their Professional Judgment and seeking doctor call clarifications of unclear scribbled prescriptions.

These goals have not yet been achieved which has necessitated continuation of this fast indefinitely.

A Message from United Steelworkers; My Request Gets No Reply

In response to my fast, the United Steelworkers Union, which oversees Medco Pharmacists and Technicians all over the country, had urged me to stop the fast and “trust in the collective power of the union to help solve this issue,” (USW letter dated July 30, 2010). I assured the President of the United Steelworkers Union Mr. Leo Gerard that I would stop this fast promptly if he translated his words into action (my letter to him dated August 6, 2010).

In that letter I asked him to negotiate with Medco and its Board of Directors to stop these wrongful practices; bring this to the attention of the public via national press; apprise the US Justice Department of the criminality of these practices; make himself available for US Senate Finance Committee hearings, and take appropriate actions to undo the damage caused to me by Medco.

Mr. Gerard has not responded to my letter, though almost 2 months have passed by. I understand that Mr. Gerard has met Medco CEO, Mr. David Snow in the month of September, in relation to this issue. We have contacted Mr. Gerard’s office and have still not gotten any definitive answers from him or the Union spokesperson.

My Final Wishes

It is very clear to me now that it has become all the more important and necessary on my part to keep continuing to fight this issue until my last breath.

No Intervention

I have made it clear that during the course of my fast, there will be no medical intervention or hospitalization for any reason including semi consciousness or coma. I have made these intentions to the legal effect very clear in my Living Will. It is 92 days now and counting that I have been carrying out this fast.

At this point of time, though I feel spiritually strong and at ease with my spirit and soul, I am uncertain as to how long my body will hold up. In the midst of this uncertainty, before it is too late, it is only appropriate that I apprise the readers, my family members, friends, supporters and members of the press here in the US and all over the world with this last message.

Keep Blogging

In the spirit of this cause, if I do not physically survive this as the days and weeks go by, it is my wish that this blog www.ihungerstrike.blogspot.com is maintained for posterity.

Collect the Facts

It is also my wish that additional facts and information we have gathered since the time I started this fast, be secured separately by my family and supporters for posterity.

Promise to Speak Up

It is also my wish that all the Pharmacists and supporters who have assured me to make themselves available to testify under oath in revelation of Medco Practices do so in the future when (sooner or later) inevitable criminal investigations and Senate hearings will be conducted to hold Medco accountable.

Medco wants me to move on and let it get away with this public safety issue, to enable the continuation of these dangerous practices unchecked. If I do so, I will be SAVING MY OWN PHYSICAL and MATERIAL EXISTENCE, and in the process LETTING DOWN MILLIONS OF TRUSTING INNOCENT PATIENTS. This practically amounts to CEASING TO LIVE ONE'S LIFE AS a HUMAN FOR THE REST OF MY LIFE, DEFYING MY OWN CONSCIENCE.

I still believe that we are living in a humane society and not in a lawless wild west. I see this as my obligation to all those 65 millions of innocent, vulnerable Medco patients that may include my own family, your family and many other families (known or unknown to us now or in the future). All these other innocent lives are as important to me as my own life, and lives of my family members. We should not be leaving the next generation of both patients and pharmacists in a state of chaos either.

Updates to be continued

We will try to provide daily updates about my continuing Hunger Strike on this blog to the extent it is physically possible for me to coordinate. At some point, if I cannot do so, we will keep my family members and supporters informed via e-mail from time to time. Concerned readers and members of the press can contact us and keep in touch via the information provided, please see, "CONTACTS". My family members/spokespersons will try to keep in touch with as many supporters as possible as dictated by the demands of the current trying circumstances.

Join the Fight

I urge the readers to POST THEIR COMMENTS ON THIS BLOG and keep the debate going. The readers can also join this fight via actions as pronounced at "WHAT YOU CAN DO.” During the past 92 days and more, via this non-violent and peaceful protest, I have been appealing to the consciences of the Institutions who have the power to take action to stop these dangerous practices. By not stopping these wrongful practices on their own accord and not accepting responsibility, the Medco CEO and its Board of Directors have CONTINUED TO ABUSE AND DISHONOR THEIR OWN PERSONAL AND COLLECTIVE CONSCIENCES. By spending more than 600,000 dollars in just the last quarter (2nd Quarter 2010) for lobbying, they continue these indefensible practices unchecked via CONTINUING collusion with the legislators and regulators.

I believe that we all are assigned specific purposes in our respective lives when we are born in this society. If my purpose in life ultimately turns out to be laying down my life to safeguard innocent fellow human beings from the crimes and sins committed against them, then I consider it is my privilege and honor to do so through my actions. Maybe only when somebody in a position like mine pays the ultimate price can we spur the individual and collective conscience of Society and bring the required changes. I also pray to God to bless all those souls who are directly responsible or are an accessory to these crimes and sins against the Society at large.

Thank You

I take this opportunity to thank all my family members, friends, supporters and journalists for all their help and support in bringing this issue to the attention of the public.

I dedicate my fight to the memories of all those people who have fought or given up their lives to fight injustices against Society in a non-violent and peaceful manner.

Rajendra “Raj” Bhat RPh

Tampa, Florida

October 4, 2010

Justice Delayed is Justice Denied

2010-09-30T15:31:00.001-04:00

For more than 7 years now... I have patiently fought this “Quota System” issue, a bad business practice of Medco Health Solutions NYSE: MHS (Medco), in every other way, investing a lot of my personal time and efforts.

This issue started way back in 2003.

Medco employed me as a pharmacist from 1995-2005 working in Tampa Florida. I served Medco with good productivity and quality records. Initially, I pleaded with Medco supervisors, earnestly explaining to them, logically, in a common sense way, why Medco Pharmacy Practices jeopardized patient health and safety and why it was not even smart to conduct the business in the manner they did.

Concerned Medco Pharmacists attended the Florida Board of Pharmacy meeting in June 2003 and brought these Practices to the attention of the Board. This Board specifically mentioned Florida Statute 465.026 as the remedy and asked us to submit a Complaint.

We were told they would promptly stop these practices. More than 40 pharmacists signed a common complaint and submitted it to the Board of Pharmacy.

What transpired afterwards was a different story. Medco employed former Board of Pharmacy members, Mr. Rod Pressnell and Mr. Roger Anderson and via a cozy relationship with the Florida Department of Health ensured that this complaint was not brought to the attention of Board of Pharmacy for immediate action as was promised.

It did not take long for me to understand that these Practices were clearly dictated by Medco CEO Mr. David Snow, who had practically no regard for patient health and safety. He had invested a great deal of Medco resources via lobbying and collusion with Regulators and Politicians. He made sure that Medco could push the envelope to the extremes to squeeze in more and more profits and keep on jeopardizing patient health and safety unchecked.

The Board of Pharmacy did not do anything to correct the situation. From February-April 2005, we pharmacists approached US Senate Finance Committee and requested the Committee to hold hearings on Medco practices. We even talked to the Committee Investigator Ms. Emilia Desantos and volunteered to testify under oath. She told us that, “the Committee had more power than the courts to subpoena various documents from Medco to get at the truth.” However, she also told us that, “Medco lobbyists were all over the place at the Senate offices.” It was clear to us that Medco used a great deal of its resources in lobbying the US Senate Finance Committee in its opposition to our request to hold Committee hearings.

Ultimately, nothing was done to stop these practices.

Later in July 2005, Medco retaliated against me by firing me four days after the Florida Department of Health decided to close the Medco Complaint after a knee jerk review, dictated by Medco. I complained to the Board of Pharmacy as well as the Senate Finance Committee about this retaliation. Department of Health Counsel representing the Board of Pharmacy via a letter to me admitted that my concern for patient safety outweighed Medco’s concern and unfortunately, I was punished by Medco. The Senate Finance Committee was indifferent and turned a blind eye.

Since all these public servants did not do the jobs for which they were hired, I was left with the only option of taking Medco to Court using my own resources.

I filed a lawsuit in 2007. The Judge denied Medco's arguments to dismiss my case and asked us to proceed with the discovery process.

During the 2 year discovery process from 2007-2009, we had taken depositions of many Medco supervisors, executives and other witnesses. We had ample evidence to substantiate that Medco was guilty of violating Florida Pharmacy Statute 465.026 of interference in a Pharmacists' Professional Judgment and the Whistleblower Statute 448.102 for retaliation.

On the completion of the discovery process in October 2009, we were given trial dates by the Judge for February 2010.

Out of the blue, Medco requested from the Judge a Summary Judgment Hearing a few days before the pretrial conference in January 2010. During the first Summary Judgment hearing in January 2010, Judge Sam Pendino stated that the statutes applied and determined that we would proceed with the trial.

Overnight he changed his decision and stated he wanted a second Summary Judgment hearing. This time he ruled in favor of Medco, despite the fact that Medco had made the same arguments during the summary judgment hearing as the ones it made in 2007 to dismiss the case in the first place when the lawsuit was originally filed.

The judge had denied Medco’s plea for dismissal of my case then in 2007.

Despite the prevalence of lot of evidence we had collected during the discovery process from 2007-2009 to substantiate the facts, the Judge ruled in 2010 in Medco's favor without a trial. This is intriguing to say the least.

The Judge also mentioned that if he were to rule in favor of me, Medco would appeal his decision and if he were to decide in Medco's favor, I would appeal his decision.

This clearly baffled me. I thought the job of the judiciary is to look at the evidence objectively and grant justice solely based on the evidence, pure and simple and not summarily determine one way or the other at the flip of a coin in a manner he approached this case and gave his judgment.

In addition, Judge Pendino made so many other statements during that hearing that did not exude any determination based on judicial Principles of Justice.

The transcripts of these hearings are part of public record and the statements of the Judge clearly indicate this. It is an indisputable travesty of Justice that Judge Pendino of the Circuit Court did not give me an opportunity via trial to substantiate all the facts revealed during the discovery process.

If any member of the legal profession or Judiciary looks at the myriad of evidence we had collected, they will have no hesitation in determining that the Judge was very unjust in deciding this case via a Summary Judgment without an opportunity for a trial.

By March 2010, we had already appealed the Judge's decision to the Second District Court and both the parties had submitted their respective briefs. But I understand the completion of this appellate procedure may take anywhere from 2-5 years. This practically amounts to "Justice delayed is Justice denied" for me as well as for the millions of Medco patients whose health and safety have been jeopardized by a continuation of these extremely dangerous Medco Practices.

Since this is a matter of great public importance, to expedite this process, we had requested the Second District Court of Appeal to certify this case directly to the Florida Supreme Court.

Our request was denied in April 2010.

Again, it is a travesty of Justice that the Second District Court of Appeal did not decide to certify this case directly to the Supreme Court as one of great public importance requiring immediate resolution in the interest of public safety. Hence, this appellate process and Supreme Court's final determination of this case could drag on for 5 years and more, at the expense of immense harm to Society leaving the Practice of Pharmacy also in chaos.

I have tried every other way to hold Medco accountable for its bad Pharmacy Practices the “Quota System” which also takes away the pharmacists’ obligation to exercise his/her professional judgment and seek doctor call clarification of unclear prescriptions.

At this time, I believe I have a moral obligation to bring this issue directly to the attention of Society at large via this hunger strike.

People have asked me why I am continuing this hunger strike at the peril to my own life. I have elaborated my thought process, mindset and moral compass on this issue in "MY FINAL MESSAGE" on the home page.

Rajendra “Raj” Bhat RPh

Tampa, FL

September 30, 2010

Readers: This post will be archived permanently under the 'tab' Justice Delayed is Justice Denied after October 6, 2010 .

National Public Radio Listens to Bhat v Medco

2010-09-19T14:28:00.001-04:00

Click here to read WMNF.org Senior Producer/Reporter Kate Bradshaw's printed story or listen to her 7-minute radio interview which starts at "minute 28".

Thank you to WMNF 88.5FM Community Radio, Tampa Florida.

-Raj Bhat RPh
Tampa, FL

United Steelworkers Writes..."Trust in the Collective Power of Your Union"

2010-09-19T14:20:00.059-04:00

July 17, 2003.
43 Tampa Florida Pharmacists sign an Official Complaint about unethical Medco pharmacy practices i.e. "the Quota System". The letter is addressed to the Florida Board of Pharmacy. Read the letter.
Friday, July 30, 2010.
The United Steelworkers Union respond to a letter from pharmacist Raj Bhat in Tampa. President Leo Gerard urges Mr. Bhat to ..."trust in the collective power of your union to help solve this (the Quota System) issue".

Friday, September 17, 2010.
Mr Fred Redmond, United Steelworkers International Vice President (Human Affairs), is interviewed by National Public Radio, WMNF.org, 88.5 FM, Tampa Florida. The interview centers around Mr Bhat's 75 day hunger strike protesting "the Quota System at Medco"; it is a dangerous business practice that must be put to a stop. Bringing the story to the court of public opinion, Senior Producer Kate Bradshaw asks the Union if there are complaints about the Quota System. He says the Union is fielding some problems in New Jersey but it is not aware of any concerns in Tampa. This is perplexing. Why doesn't Fred Redmond give all the facts in their proper perspective? Want to hear the 7 minute interview? or read the interview article? (LISTEN or READ - CLICK HERE)

Please read the (7/30/2010) USW letter to Raj Bhat and make an informed decision for yourself as to why Mr Redmond is trying to evade the (Quota System) issue.

Transcript of Letter

to Raj Bhat RPh, Tampa Florida

from Leo Gerard, United Steelworkers International President.

July 30, 2010

Dear Mr Bhat:

We were very moved by your letter of July 24, 2010. The cause you are fighting for - the right of workers and professionals to be free from corporate speed-ups which endanger not only themselves but also the public - is one which the USW is fighting for as well. Be assured that the USW will be raising this issue with Medco in bargaining so that we can help to create a more humane and safe workplace as well as to ensure consumer safety. Indeed, as you can see from the following article, the USW is already advocating on behalf of pharmacists at Medco on this very issue. Read article.

In the meantime, while your willingness to put your life on the line through a hunger strike to highlight this issue is admirable, we urge you to cease that action immediately and to trust in the collective power of your union to help solve this issue. We need you healthy and strong to help us with this fight.

Sincerely yours,
Leo W. Gerard
International President

Fred Redmond
International Vice President (Human Affairs)

USW. Five Gateway Center, Pittsburgh, PA 15222.
412.562.2400
http://www.usw.org/

-RB

9/19/2010

75 Days and Counting. Raj Bhat Tells His Story again...

2010-09-17T17:45:00.001-04:00

Why Medco CEO David Snow Should Step Down.

2010-09-08T15:36:00.003-04:00

Medco Health Solutions, Inc. (NYSE: MHS) “Medco”, continues to make false claims that it sets no quotas for pharmacists and that it works hard to fill prescriptions safely and accurately.

These claims are false.

The pharmacists who have worked for Medco, the United Steelworkers Union which represents both Technicians and Pharmacists at Medco and others who have inside knowledge of how Medco operates, have clearly provided the undisputed facts to the contrary. Here is one example: read IndyStar article of July 24, 2010.

Medco claims that its world-renowned technology has revolutionized the pace at which prescriptions are processed and has even gone to the extent of claiming zero-errors in dispensing the correct drug, correct dosage and correct form. What Medco is fraudulently misrepresenting to the public is its "world-renowned technology" in the form of robots does not commit any errors at all.

I would like to clarify the facts.

If a human pharmacist completely and accurately checks all the prescription information at the front-end and then robots get accurate data to fill prescriptions at the back-end, robots do not commit errors on their own.

Reading the Scribbled Prescription Takes Time.

It is an established fact that doctors handwrite the majority of prescriptions processed at Medco, which necessitates significant requirements to clarify the MD’s intent, especially if scripts are scribbled or not clear. Irrespective of the type of script (handwritten or electronic), the fact remains that every prescription is required to be read and entered manually by a technician or a pharmacist at its (Medco’s) front-end pharmacy and then “final checked” by a pharmacist for accuracy. The new technology has not (and will not) change that.

Doing Your Job in 25 Seconds, or Less?

The unsafe pace at which Medco pharmacists are forced to work is less than 25 seconds per prescription during the “final check” phase. While these prescriptions are entered into the computer by a technician, the pharmacist cannot completely, consistently and accurately check for medication errors at this pace.

It is only inevitable that medication errors would happen left, right and center.

These “25 seconds” do not discriminate between fatal errors and non-fatal errors.

No Stopping a Robot.

Once these errors are committed at the front-end, robots, which fill the actual medication order, cannot stop these errors at the back-end.

Follow the Rules? No Time for That.

Medco’s Standard Operation Procedure (SOP) mandates that every aspect of prescription information be thoroughly verified. It is hypocritical as well as unconscionable on the part of Medco to demand pharmacists to follow SOP policies and not give them enough time to do it. If any pharmacist with a macho cavalier attitude brags that he can completely and accurately enter-and-check a prescription in less than 2 minutes per prescription or “final check” a prescription, entered by a technician, in less than 25 seconds per prescription, he/she is talking only as Medco spokesperson and not talking in the interest of patient health and safety.

Doctor, I have a Question… ***click***

Medco does not like pharmacists requesting a “doctor call” to clarify unclear aspects of a prescription, because it costs Medco more money to do so and reduces profits. Hence, Medco policy penalizes and disciplines pharmacists who are duty-bound to exercise their professional judgment and initiate these “doctor call” clarifications.

What about those preventable errors caused by unclear prescriptions but not sent to “doctor call” clarifications attributable to pharmacists' who fear of Medco retaliation?

Medco’s been Warned!

It is not just me talking about this issue here.

The U.S. government has had similar concerns about these Medco practices. In the case of United States of America v, Merck Medco Managed Care, L.L.C., Civil Action No. 00-737 (D. Pa.), The Federal District Court ordered Medco to conform to the following requirements, which states:

• "Medco shall adopt the code of ethics of the American Pharmacists Association for its employed pharmacists"

• "Medco shall require its pharmacists to comply with all state law requirements governing pharmacists"; and

• "Medco shall permit its pharmacists to give good faith, professional opinions."

Bhat v. Medco.

In contravention of this court order (which Medco CEO, Mr. David Snow agreed to honor in writing) Medco retaliated against me via disciplinary actions for exercising good faith professional opinions/judgment and terminated me despite better work performance than many other pharmacists employed at Medco during the same time period.

Medco in its press briefings is insisting that I was given repeated warnings for poor (work) performance and cites this as the cause for terminating my employment. What Medco refers to as so-called poor performance was apparently attributed to my seeking “doctor call” clarifications of unclear prescriptions in the interest of patient health and safety. Every prescription had a legitimate reason for seeking “doctor call” clarification.

Retaliation?

Medco has admitted that I was the only pharmacist fired attributable to what it terms so-called poor performance.

Local unions have all the knowledge and information to refute Medco’s contention.

It is a common knowledge of fact among Medco pharmacists in Tampa Florida that I was retaliated against. Even JCAHO (Joint Commission on the Accreditation of Healthcare Organizations), which investigated my firing, had determined that I was subjected to unwarranted disciplinary actions despite good performance and legitimate requests for clarifications of unclear prescriptions. My seeking “doctor call” clarifications were just a front to rationalize and cook up a cause for my firing.

David Snow is Guilty.

In reality, the real unjustifiable cause for termination was a form of retaliation for raising concerns with the Florida Board of Pharmacy and with Medco’s CEO Mr. Snow about illegal Medco practices.

Mr. Snow's is responsible for damages caused to me as a whistleblower.

Mr. Snow is also accountable for the consequences of having placed me in a peaceful, non-violent, hunger strike – protest beginning on July 5, 2010 to date (September 8, 2010).

Says Whom?

The Director of Pharmacy Practices at Medco has subjective discretion to determine whether a medication error should, in fact, be charged as an error to the pharmacist or just dismissed as “FYI” (“For Your Information”) only. When such a determination is made, pharmacists in Medco’s “good books” i.e. cooperating with wrongful practices are not charged for errors. The pharmacists whom Medco does not like i.e. resisting these wrongful practices, are easily victimized.

There is a great amount of leeway to cook the figures when it comes to reporting quality as well. All these things go on unchecked inside the corridors of this pharmacy giant at the expense of public health and safety.

Bad Pears, Bad Pills …Not the Same Thing.

Any consumer, who buys a product at a grocery store, can identify himself/herself that a product is bad, and can exercise his/her rights to return that product for a replacement or a refund.

Many a time, an innocent patient looking at their pills does not even know whether he/she is getting the right or wrong medication.

For the same reason, when a prescription error turns out to be fatal, the patient may not know that the fatality was caused by the wrong medication and may not even report the error. Hence, significant portions of the errors are not reported at all, at the expense of patient health and safety.

This is about Trust. Credibility. Justice.

A rogue company like Medco, banks on the innocence of these trusting patients to rake up profits at the expense of their safety.

Do we have to wait until a family member, a child of a celebrity or one of our own die attributed to a fatal prescription error before a public Senate committee hearing and a criminal investigation of these wrongful Pharmacy Practices takes place?

Are regulators working in collusion with a company like Medco, facilitating the continuation of wrongful practices? Will they have any credibility, if they plead innocence and resort to the usual rhetoric on national TV after the facts are established via a criminal investigation in future?

I have clearly explained on my blog why Medco practices amount to institutionalized criminal negligence and why pharmacists who volunteer or are forced to participate in these practices are criminally liable.

The Facts.

In the context of facts presented here, I will explain, again, why Medco’s business practices are institutionalized criminal negligence for the benefit of the readers.

Since 2005, there have been significant developments concerning pharmacists' liability and accountability for medication errors. Click pharmacy errors for ten recent examples of errors and consequences as recorded by Florida attorney Scott Distasio.

In one case, a pharmacist has been found criminally liable. I am sure you are aware of the Ohio Pharmacist, Mr. Eric Cropp who was found criminally liable and charged with involuntary manslaughter. Child Emily died because of sodium chloride overdose, a medication error committed by Mr. Cropp’s technician. Please take time to look at a CNN interview by David Mattingly of Mr. Cropp filmed while he was imprisoned. Click or go to http://www.ihungerstrike.blogspot.com/ “Research and Information”. Mr. Cropp also lost his Pharmacist license and had to serve his time in prison. It was obvious that working conditions limited his ability to directly supervise his technician who caused the error. All the same, the court did not accept his defense.

Will You Need a Lawyer if You Work at Medco?

If a similar error were to happen at Medco, Medco pharmacists cannot put up a criminal defense that working conditions at Medco did not allow him/her to directly supervise his/her technician.

In a criminal court of law, a Medco pharmacist would not be able to put up a defense that he/she committed an error by not clarifying unclear aspects of a prescription because of the employer's working conditions (threat of disciplinary actions including termination for requesting “doctor call” clarification).

Professional Judgment – Leave it in Your Locker.

With CEO Mr. David Snow's knowledge and under his directive, Medco has continued these wrongful practices of questioning the Pharmacists' Professional Judgment (see Code of Ethics) in relation to his/her requests for doctor clarifications of unclear aspects of the prescription. Under his leadership as you all know now, Medco undoubtedly has embraced the “quota system” and does not allow pharmacists enough time to check prescriptions completely and accurately following its own SOP. This “quota system” pressures pharmacists to enter-and-check an unreasonable and unsafe target of 45- 55 prescriptions per hour and more. This “quota system” also pressurizes technicians to enter 55 prescriptions per hour and more and pharmacists to “final check” prescriptions entered by technicians at the unsafe target of 130-150 prescriptions per hour and more. These practices, which cause increased number of medication errors, are implemented by threats of disciplinary actions and termination and these practices undoubtedly constitute an employer's act of criminal negligence.

Snow: Profits, Yes. Safety, Not So Much.

Mr. Snow has clearly put Company profits over Patient Safety. Hence, the direct and ultimate responsibility for this act of criminal negligence lies with Medco CEO Mr. David Snow.

It is only appropriate and required for the US Department of Justice to intervene again and hold Medco accountable for violation of Federal District Court order United States of America v. Merck Medco Managed Care, L.L.C., Civil Action No. 00-737 (D. Pa.). It is high time that US Department of Justice orders a criminal investigation against Medco’s CEO in the interest of Public Health and Safety. It must safeguard the interests of the shareholders as Medco describes its business as Clinically Driven Pharmacy Services Designed to Improve Quality of Care.

Standard of Care: Not in Compliance.

The facts and truth I have provided here prove conclusively that Medco does not even conform to basic "Standard of Care" required to be complied with legally by all health care organizations.

What kind of quality care can any pharmacy company provide, if the pharmacists are not allowed to exercise their professional judgment in the interest of the health and safety of patients?

What kind of quality care can any pharmacy company provide if it adapts a “quota system” and does not allow pharmacists enough time to completely and accurately check prescriptions following its own SOP (Standard Operation Procedure)?

Attention Financial Advisors, Analysts and Stock Pickers.

Medco has a legal obligation to own up and provide all the information about these wrongful business practices to financial advisors like Mr. Ravi Sachdev, formerly of Deutsche Bank (now hired by JP Morgan Chase) and stock analysts who own-and-tout MHS, such as Mr. Jim Cramer of CNBC’s Mad Money with Jim Cramer .

These financial advisors and stock analysts also have a legal obligation to provide these details of Medco business practices to the Medco shareholders. All Medco shareholders have the right to know how Medco achieves so-called ''Quality of Care" with these business practices, before they invest and continue to invest their hard earned money in the company.

“Not his job,” says Snow?

Despite all the facts and raw, naked truth I have presented here, Mr. David Snow is still not accepting responsibility. He has not taken action to correct its unsafe business practice known as the “quota system” to the detriment of excellent pharmacy care, patient safety and health, and shareholders who have the right to an informed decision.

Step Down. Face Up.

If Medco does not own up and take responsibility to correct the "Quota System" situation in every way, including informing its shareholders, it is only appropriate and imperative that Mr. David Snow should step down.

Prepared by:

September 8, 2010
Rajendra “Raj” Bhat, RPh
Tampa, Florida

Shown above 7/3/2010 - preparing for his fight for justice, Raj Bhat RPh. Tampa FL. USA.

On July 5, 2010 Rajendra "Raj" Bhat began a hunger strike to protest unsafe business practices known as the "Quota System" at Medco Healthcare Systems, Inc. This report was compiled and written by Mr Bhat on the 66th day of his peaceful, non-violent protest, September 8, 2010.

www.ihungerstrike.blogspot.com
rajbhattampa@gmail.com

Day 66.

2010-09-08T01:00:00.001-04:00

The peaceful, non-violent fight for JUSTICE continues. Hunger strike DAY 66.

Day 65

2010-09-07T10:08:00.003-04:00

My non-violent, peaceful fight for JUSTICE continues.
Hunger Strike! Day 65.

Raj Bhat Pharmacist
Tampa Florida

Day 64

2010-09-06T01:00:00.000-04:00

This protest has continued for 64 days. I protest Medco and its Quota System. This is a peaceful, non-violent protest for JUSTICE. Day 64 of my hunger strike.

-Raj Bhat Tampa Florida
a pharmacist who cares about patient safety and worker's rights
Labor Day 2010

Day 63

2010-09-05T01:00:00.001-04:00

I have now protested Medco for 63 days.

I continue to protest Medco without food; as a hungerstrike.

I fight for justice, non-violently, peacefully.

I ask for justice.

-Raj Bhat RPh a pharmacist from Tampa, FL

Day 62

2010-09-04T12:26:00.000-04:00

I have protested Medco for 62 days.

I protest Medco without food; as a hungerstrike.
I fight for justice, non-violently, peacefully.
I ask for justice.

-Raj Bhat RPh
Tampa, FL

Day 61

2010-09-03T19:05:00.000-04:00

The peaceful, non-violent fight for JUSTICE continues. DAY 61. I protest.

Day 60. A Hunger Strike for Justice.

2010-09-02T05:00:00.002-04:00

My peaceful, non-violent protest for JUSTICE continues.

Hunger Strike Day 60.

-Raj Bhat RPh
Tampa, Florida

Day 59

2010-09-01T06:00:00.001-04:00

My peaceful, non-violent protest for JUSTICE continues.

Hunger Strike Day 59.

-Raj Bhat RPh

Tampa, Florida

Day 58

2010-08-31T09:20:00.000-04:00

My peaceful, non-violent protest for JUSTICE continues.
Hunger Strike Day 58.

-Raj Bhat RPh
Tampa, Florida

Day 57

2010-08-30T15:01:00.001-04:00

My peaceful, non-violent protest for JUSTICE continues.
Hunger Strike Day 57.

-Raj Bhat RPh
Tampa, Florida

Day 55

2010-08-28T13:49:00.002-04:00

My peaceful, non-violent protest for JUSTICE.
Hunger Strike Day 55.

-Raj Bhat RPh
Tampa, Florida

Hunger Strike continues to Day 54

2010-08-27T08:24:00.001-04:00

It has now been 54 days of this hunger strike. This hunger strike is my peaceful protest.

I am protesting Medco. I am challenging it to stop the Quota System. This is a fight for justice. Send your voice to the cause. Stop the Quota System. Speak up. Speak out.

Thank you for speaking up on behalf of patients who will certainly receive incorrect medicines and medicine errors because Medco insists that pharmacists work faster, faster, faster.

Speak up. Speak out.

Raj Bhat a pharmacist from Tampa Florida who cannot turn a blind-eye to Medco
August 27, 2010
Friday

Day 53

2010-08-26T17:22:00.000-04:00

My peaceful, non-violent fight for JUSTICE continues.
Hunger Strike Day 53.
-Raj Bhat RPh

Day 52

2010-08-25T12:16:00.000-04:00

Now 52 days, my hunger strike continues, as well as my peaceful, non-violent fight for justice.

-Raj Bhat RPh

Wednesday, August 25, 2010

Day 51

2010-08-24T18:14:00.000-04:00

The non violent, peaceful fight for justice continues.
Day 51.

-Raj

Day 50.

2010-08-23T09:40:00.001-04:00

Today is the 50th day of my hunger strike.
My peaceful, non-violent fight for justice continues.
-Raj

Day 49

2010-08-22T00:07:00.001-04:00

My peaceful, non-violent fight for justice continues. Today is the 49th day.
- Raj

Day 48

2010-08-21T19:36:00.000-04:00

Peaceful, non-violent fight for justice continues.
- Raj

Day 47.

2010-08-20T00:19:00.000-04:00

Peaceful non-violent fight for justice continues.
Day 47.
-Raj

Day 46

2010-08-19T19:07:00.000-04:00

Peaceful non-violent fight for justice continues.
Day 46.

-Raj

Day 44

2010-08-17T23:39:00.002-04:00

Day 44. My peaceful protest against Medco continues. -Raj

Letter to the North Carolina Board of Pharmacy

2010-08-14T12:10:00.007-04:00

Rajendra Bhat RPh
Tampa Florida

July 20, 2010

Faxed to 919-246-1056
Sent via Certified Mail

Attention Connie Manion
North Carolina Board of Pharmacy
6015 Farrington Road Suite 201
Chapel Hill, NC 27517

Dear Sir or Madame:

I am a Florida licensed pharmacist. I am bringing to your attention wrongful illegal practices followed by Medco Health Solutions, which caters to millions of patients in the State of North Carolina. Medco corporate headquarters is located at

100 Parsons Pond Drive, Franklin Lakes, NJ 07417

These wrongful practices are as follows:

a) Pressuring pharmacists to enter and check 45-55 prescriptions per hour
b) Pressuring technicians to enter up to 55 prescriptions and more per hour and pressuring pharmacists to check prescriptions entered by technicians at the rate of 130-150 prescriptions per hour
c) Penalizing and retaliation against pharmacists for exercising their professional judgments

These unreasonable check rates have lowered quality standards by many folds and thereby have jeopardized patient health and safety.

Medco is in violation of North Carolina Statute “21 NCAC 46.1811 EXCESSIVE DISPENSING OF PRESCRIPTION DRUGS”.

Presently, I am on a hunger strike protesting these practices. For more information please go to my blog at www.ihungerstrike.blogspot.com and my Facebook page Raj Bhat RPh Hunger Strike v Medco. If you have any questions, please call me.

Thanks,

Sincerely,
/s/ Raj Bhat RPh

Enclosure: letter to Medco CEO Mr. David Snow

Day 41

2010-08-14T09:14:00.000-04:00

Day 41. My peaceful protest against Medco continues.

Raj Bhat RPh
Tampa FL

Day 40

2010-08-13T00:42:00.000-04:00

Peaceful, non-violent protest against Medco continues. Day 40.
August 13, 2010

Raj Bhat RPh
Tampa FL

Day 39

2010-08-12T23:29:00.000-04:00

Non violent, peaceful protest continues against Medco. Day 39. August 12, 2010.
-Raj Bhat RPh

Letter to US Senator Bill Nelson (FL)

2010-08-07T10:56:00.000-04:00

Faxed to (407) 872-7165
Also sent via certified mail

July 26, 2010

Honorable US Senator Bill Nelson
Landmark Two
225 East Robinson Street, Suite 410
Orlando FL 32801

Washington, D.C. Office
United States Senate
716 Senate Hart Office Building
Washington, DC 20510
Phone: 202-224-5274
Fax: 202-228-2183

Dear Senator Nelson:

I am in receipt of your letter dated July 16, 2010.

Around 2003-2005, I had brought to your attention in detail the wrongful practices at Medco which had jeopardized patient health and safety. I had requested you to help us Medco Pharmacists to testify in front of Senate Finance Committee.

I am constrained to express here that you did not do anything to help us in this regard.

Medco, via a cozy relationship with the Florida Board of Pharmacy and the Drug Enforcement Agency (DEA), made sure that no corrective actions were taken. Medco continued with these wrongful practices of pressuring pharmacists to enter and check up to 45-55 prescriptions per hour and interfering with pharmacist's professional judgment. These practices have become worse. As of now, they are pressuring technicians to enter up to 55 prescriptions per hour and more, and pressuring pharmacists to check up to 130-150 prescriptions per hour. By any standard of common sense and reason, it is impossible for a pharmacist to check a prescription in less than 25 seconds per script completely and accurately without cutting corners and consequently committing errors.

This is not a legal issue. I have an attorney to deal with my legal situation. I am not asking you to interfere in my legal situation or the judicial process in any way.

The purpose of my letter is to raise concern about a public health and safety issue.

I am pleading with you as a Senator to step up to the task of initiating action to challenge Medco about its prescription-filling practices, talk to your fellow Senators, to do your job, to conduct a Senate inquiry and hearings and hold Medco accountable.

It is high time these practices are stopped.

If you do not stop these practices, you will have a situation comparable to the BP oil spill, which could have been easily prevented if the Regulators and the Legislators had done their part of their jobs for which they were hired.

Today is 22nd day of my hunger strike. I am doing this as a moral outrage to bring attention about Medco to the public at large. By this process, I am not only holding Medco accountable, but also the Regulators and Legislators who do corporate bidding and do not serve in the interest of the public. For more details, see my blog at http://www.ihungerstrike.blogspot.com/ or my Facebook page (Raj Bhat RPh Hunger Strike v Medco) and interesting links and research from my blog.

The Indianapolis Star and Baltimore Sun have already published articles on this issue.

I respectfully request you to act and not come up with any excuse not to act. Time is practically running out for me. I am going to put this letter on my blog as additional documentation about Medco for posterity. You can contact me or my spokesperson, Mrs. Dawn Hudson via email at rajbhattampa@gmail.com

Rajendra “Raj” Bhat

Attached: Indianapolis Star article A bitter pill for Medco, John Russell

A Letter to JCAHO (Joint Commission on Accrediation of Healthcare Organizations)

2010-08-07T09:55:00.002-04:00

July 26, 2010

Premier Safety Institute
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
One Renaissance Blvd
Oakbrook Terrace, IL 60181
http://www.jointcommission.org/

Dear Sir or Madam:

Around 2003-2005 I had brought to your attention in detail the wrongful practices at Medco which had jeopardized patient health and safety. I had requested you to help us Medco Pharmacists to intervene and stop these Medco practices. I am constrained to express here that you did not do anything to help us in this regard. Medco, via a cozy relationship with the (Florida) Board of Pharmacy and DEA (Drug Enforcement Agency), made sure that no corrective actions were taken.

Medco continued with these wrongful practices pressuring pharmacists to enter and check up to 45-55 prescriptions per hour and interfering with pharmacist's professional judgment. In July 2005, Medco retaliated against me and fired me for raising these concerns with the (Florida) Board of Pharmacy and Medco CEO, Mr. David Snow.

I had complained to you after I was fired. You did conduct an investigation and found that I was issued unwarranted disciplinary actions despite my good performance. However, you did not take any action to stop these dangerous practices.

Your inaction has proved to be highly detrimental.

These practices have become worse.

As of now, Medco is pressuring technicians (who have limited knowledge of medications) to enter up to 55 prescriptions per hour and more, and pressuring pharmacists to check up to 130 -150 prescriptions per hour. By any standard of common sense and reason, it is impossible for a pharmacist to check a prescription in less than 25 seconds per script completely and accurately without cutting comers and consequently committing errors.

This policy is a public health and safety issue.

I am pleading with you as a rating and accreditation agency to step up to the task, conduct an inquiry and hold Medco accountable. It is high time these practices are stopped. If you do not stop these practices, you have a situation comparable to the BP oil spill, which could have been easily prevented if the Regulators, Rating Agencies and the Legislators had done their part of their jobs for which they were hired.

Today is 22nd day of my hunger strike. I am doing this as a moral outrage to bring these Medco practices to the attention of the public at large. By this process, I am not only holding Medco accountable, but also the Regulators, Rating Agencies and Legislators who do corporate bidding and do not serve in the interest of the public.

For more details, see my blog at www.ihungerstrike.blogspot.com my Facebook page (Raj Bhat RPh Hunger Strike v Medco) and interesting links and research from my blog. The Indianapolis Star and the Baltimore Sun have already published articles on this issue.

I respectfully request you to act and not come up with any excuse not to act.

Time is practically running out for me. I am going to put this letter also as documentation for posterity.

You can contact me or my spokesperson, Mrs. Dawn Hudson via email rajbhattampa@gmail.com

Sincerely,

Rajendra Bhat
Tampa Florida

Attached: Article published by Indianapolis Star

Day 34

2010-08-07T09:37:00.000-04:00

Peaceful, non-violent protest for Justice continues. Day 34.
Saturday, August 7, 2010.

Raj Bhat RPh
Tampa FL

Day 31

2010-08-04T19:25:00.000-04:00

Peaceful non-violent protest continues. Day 31.

Raj Bhat RPh

Thank you for visiting

2010-08-01T21:34:00.001-04:00

Thank you and welcome to the visitors to this website since July 5, 2010.

Post for
Raj Bhat
Tampa Florida
August 1, 2010
Hunger Strike Day 28

Day 24.

2010-07-28T19:51:00.000-04:00

This is a most difficult time.

I am asking pharmacists to stick together, to speak up about poor management practices especially being pressured to enter and check more prescriptions than is reasonable and safe. The future of our profession demands an ethical work environment.

Lend your name to the list of witnesses. You can remain anonymous.

Posted for Raj Bhat
July 28, 2010
7:50pm

APOTHEKE ADHOC -- Apotheker im Hungerstreik

2010-07-28T16:13:00.000-04:00

APOTHEKE ADHOC -- Apotheker im Hungerstreik

Thank you to Apotheke Adhoc, a pharmacy magazine from Germany for carrying the news about the Quota System.

-Raj

More News.

2010-07-26T23:58:00.000-04:00

Coverage of the Bhat v Medco story continues to spread thanks to journalist George Joseph of India Abroad. Click title above or link (sidebar) to read the article.

Day 22 of my hunger strike

2010-07-26T09:52:00.003-04:00

Conserving all energy, I am losing some strength but still of clear mind.

My hunger strike brings clarity to the fight to preserve all pharmacists work ethics especially in the e-pharmacy and highly automated settings.

I protest the Quota System management concept. It is wrong, unsafe, unethical.

Eventually, the Quota System will be fatal to enough patients until Medco is reigned in or perhaps the government will push through the bureaucracy or will it be a news outlet with a tenacious investigative reporter who won't take no for an answer?

July 26, 2010. Day 22 of my hunger strike. My entire focus is my concern for people who take prescription medicine...and get the wrong dose, or the wrong medicine entirely, or the wrong instructions (medicine errors from a pharmacy kill). Management at Medco has implimented a hurry up and give us your best guess attitude instead of a compassionate and professional setting (Code of Ethics in full use).

Speak up. Speak out.

If you fear retaliation, please know you will be protected.
I am building a list of supporters and all the information of any kind I can gather at the suggestion of the US Senate Finance Committee.

-Raj

A Bitter Pill for Medco?

2010-07-24T13:16:00.000-04:00

Today, Saturday, July 24, 2010.

Medco expands to Indiana and the local press takes a long look at the world's largest pharmacy company.

Hat tip to journalist John Russell for a job well done.

-Raj
Time is of the essence. Speak Up and Speak Out if you have concerns about *Quota Systems* which interfer on RPh's Professional Judgment. Email me via the Help! page. RB

How It Looks From Here: The Medco Model of Customer Service

2010-07-23T23:05:00.000-04:00

How It Looks From Here: The Medco Model of Customer Service

A Letter to Mr. Leo Gerard, International President of the United Steelworkers Union

2010-07-23T22:16:00.001-04:00

Message to Mr. Leo Gerard, International President - United Steelworkers Union
July 23, 2010

From 1995-2005 I was employed by Medco as a pharmacist. I was fired as a whistleblower due to my concerns about pharmacy ethics and patient safety relating to Medco prescription-filling policies. Unfortunately, since 2005 not much has changed at Medco, in particular, Medication Error rates; they have increased and error reporting standards have dropped. This is fixable.

On July 5, 2010 I launched a hunger strike to bring attention to the unconscionable practices at Medco mandated by top management. My story caught the attention of United Steelworker union representatives who are also battling with Medco.

Time is of the essence. Let’s organize and let’s prevail.

Mr. Gerard, I listened to you on MSNBC a few months back defending the victims of the mining disasters your union was representing. You were also critical of the CEO of the mining company for his callousness. It is unfortunate that you were addressing these issues "after the fact". If these safety issues were dealt with proactively, the lives of so many miners could have been saved.

The United Steelworkers Union under your leadership is also representing the employees of Medco pharmacies all over the United States including the one here in Tampa Florida. It is ironic that your union is faced with a similar situation (profits over safety) in relation to Medco.

The difference here is victims of Acts of Criminal Negligence on the part of Medco are not just the pharmacist-employees, but also include the public at large in the form of millions of patients who get prescription benefits from Medco. I also understand that up to 30- 40% of patients who get prescriptions from Medco are United Steelworkers Union members and their families all over the country. (Please correct me if I am wrong).

The following wrongful practices have jeopardized patient health and safety and constitute an Act of Criminal Negligence by Medco:

a) Pressuring pharmacists to “enter and check” 45-55 prescriptions per hour

b) Pressuring technicians to enter up to 55 prescriptions and more per hour and pressuring pharmacists to check prescriptions entered by technicians at the rate of 130-150 prescriptions per hour.

c) Penalizing and retaliating against pharmacists for exercising their professional judgment during the course of their work.

If a Medco pharmacist makes a claim that he/she can “final check” a prescription in less than 25- seconds- per- script, without any errors, he/she is only speaking up as a Medco spokesperson and not in the interest of public safety.

By any standard of reason and rationality, it is impossible for a pharmacist to completely and accurately verify and check a prescription entered by a technician in less than 25 seconds per prescription without committing errors.

In 2002 the maximum number of prescriptions a pharmacist was “entering and checking” (without tech help) was around 30 prescriptions per hour. At that time, the quality was very good. By pressuring pharmacists to “enter and check” more and more number of prescriptions coupled with the threat of disciplinary actions, the quality of work deteriorated many folds. That means the Medication Errors increased by many folds and multitudes of Medco patients received wrong medications.

Even one extra Medication Error attributed to these practices is too many. Any one of these errors could prove to be fatal and could affect any of the millions of Medco patients, including millions of Union members and their families all over the country.

I fervently appeal to you to act proactively and hold Medco accountable for its unconscionable management decisions. Union negotiations should not just revolve around getting better remuneration for the employees. It should also involve issues related to preventing and stopping Acts of Criminal Negligence and ensuring public health and safety.

From all the evidence we have gathered since 2005, it is an undisputed fact that I was retaliated against by Medco for raising these professional concerns with the Florida Board of Pharmacy and Medco CEO, Mr. David Snow. This despite having good productivity and quality work records for nearly 10 years of service with Medco (1995-2005).

I have presented my case with all its particulars on my blog (www.ihungerstrike.blogspot.com). All these details are being documented for posterity.

Time is practically running out for me. I do not have any ill will against Medco.

I am carrying on this fight with undivided attention to stop these dangerous practices, clear my name and undo the damage done to me.

I hereby appeal for your support in terms of positive actions to achieve these objectives.

Expecting to hearing from you,
Thank you.

Raj Bhat RPh
Tampa Florida

A Letter to Medco. A Reply from Raj Bhat RPh.

2010-07-20T11:38:00.004-04:00

Open Response to Medco from Raj Bhat RPh.
July 20, 2010

I am responding to the following response from a Medco spokeswoman to journalist Mr. Ed Silverman's log on July 14, 2010.

Whistleblower Fired
She wrote: "Medco's Office of Ethics thoroughly investigated Raj Bhat's issues and found that they were without merit or foundation. Mr. Bhat's issues were also investigated by the Florida Board of Pharmacy and were found without merit or foundation. In addition, Mr. Bhat's allegations were dismissed by the court in January 2010, when Medco won summary judgment. Mr. Bhat's termination was based solely on poor performance and his failure to raise performance levels to acceptable standards - despite repeated warnings."

43 Pharmacists Agree!
I would like to respond as follows.

The “issues” Medco is referring to here were not just mine. They were also the issues of more than 40 other Medco pharmacists who signed a formal Letter of Complaint to the Florida Board of Pharmacy in 2003. The Complaint was about unsafe and dangerous practices (Practices) directed by order of Medco CEO Mr. David Snow. These work practices pressured pharmacists to enter and check 45-55 prescriptions per hour and directly interfere with a pharmacists Professional Judgment.

Unsafe at Medco even in 2010
As of July 20, 2010 these unsafe Practices remain unchanged at Medco.

Medco Ethics - A Sham
Medco's Office of Ethics was headed by Mr. Michael Clark, who was basically a Medco Attorney (not an independent institution). Mr. Clark was acting directly under the order of CEO Mr. David Snow.

Why would Medco appoint an Attorney from its own legal department to head Medco’s so-called "Office of Ethics" if Medco was serious about the ethics and morality? In fact, Mr. Clark was representing the legal department to facilitate implementation of these practices. Medco's Office of Ethics is just a sham. If Mr. Clark were to make a determination against these Medco practices, would he have continued to keep his job under Mr. Snow's stewardship? Obviously not.

Complaint to Florida RPh Board
I would like to throw some light on the Florida Board of Pharmacy. Concerned Medco Pharmacists attended the Board of Pharmacy meeting in June 2003 and brought these Practices to the attention of the Board. The Board specifically mentioned Florida Statute 465.026 as the remedy and asked us to submit a Letter of Complaint and we were told they would promptly stop these practices.

Why would the Board ask us to submit a complaint if our concerns (Medco terms them as Issues) were without merit or foundation?

Medco Hires Regulators – Complaint Closed
What transpired afterwards was a different story. Medco employed former members of Boards of Pharmacy, Mr. Rod Pressnell and Mr. Roger Anderson and, via a cozy relationship with the Florida Department of Health ensured that our 43-person Letter of Complaint was not brought to the attention of the Board of Pharmacy for immediate action as was promised. The so-called investigation was prolonged for more than 2 years citing that the Florida Department of Health did not have trained personnel to do the job and ultimately it decided to close the Complaint after a knee-jerk review.

Judge Says Proceed -2007
Judge Sam Pendino could have dismissed my case when my Legal Complaint was initially filed in June 2007, if he thought my complaint was without merit or foundation. He did not dismiss my case. And he ordered us to proceed with the discovery process. Medco had made the same kind of arguments for dismissal in 2007 as to what it argued during the Summary Judgment hearings in 2010.

Evidence Gathering Takes 2 Years
A two-year long discovery process clearly revealed the following.

Fired Without Merit
1. Medco’s contention of my poor performance was without merit or foundation, since my performance was better than many Medco pharmacists who were not fired. Discovery process has clearly established this. This action of retaliation against me is common knowledge among Medco pharmacists. Each and every prescription I had sought “Doctor Call” clarification was for a valid reason in the interest of patient health and safety and legality. I was looking forward to substantiating this during the course of trial.

Bhat Singled Out
2. Medco has admitted that I was the only pharmacist who was fired for so-called "poor performance" (as alleged by Medco).

More Proof
3. JCAHO (Joint Commission on Accreditation of Health Organization) had conducted an investigation of my firing. It clearly substantiated that despite my good performance I was issued unwarranted disciplinary actions. It has clearly revealed the Medco conspiracy of retaliation for raising concerns with the Florida Board of Pharmacy and with Medco CEO, Mr. David Snow.

The Judge Flip Flops Overnight…
There were two summary judgment hearings in January 2010. During the first hearing, Judge Pendino clearly pronounced that the statutes applied and asked us to proceed with the pre-trial conference. A few days later when we met him, he wanted to revisit this and asked us for a second summary judgment hearing. During the second summary judgment hearing, he reversed himself and granted summary judgment in favor of Medco. This reversal of decision is a mystery to me. Transcripts of both summary judgment hearings are part of public record.

Fight Takes Years
It is a travesty of justice that Judge Pendino did not give me an opportunity via trial to substantiate all the facts including those pertaining to Medco’s corporate retaliation conspiracy against me that were clearly revealed during the discovery process. Through my attorney, we have already appealed Judge Pendino's decision to the Second District Court of Appeal.

I have been given to understand that this whole judicial process may take anywhere between 2-5 years. What that means is "Justice Delayed is Justice Denied.” Since this issue is of great public importance, we requested the Second District Court of Appeal certify this case directly to the Supreme Court for immediate resolution as it concerns public safety.

The Second District Court of Appeal decided not to certify this case directly to the Supreme Court. By delaying Justice, these institutions have also fundamentally denied justice, not just to me, but also to the public at large.

Undisputed Truth – Or Why Bother?
All the information I brought to the attention of the public here are truthful, undisputed facts and not a matter of opinion.

Medco, Change Your Practices
I once again appeal to Medco, its Board of Directors and shareholders to stop these following practices.

a) Pressuring pharmacists to enter and check 45-55 prescriptions per hour.
b) Pressuring technicians to enter up to 55 prescriptions and more per hour and pressuring pharmacists to check prescriptions, entered by technicians, at the rate of 130-150 prescriptions per hour.
c) Penalizing and retaliating against pharmacists who exercise their professional judgments.

Medco, Undo the Damage
I also appeal to Medco to accept the facts and ultimate truth and undo the damage done to me.

A Message for Posterity from “Some Pharmacist”

IF MEDCO CONTINUES TO DISREGARD THESE FACTS AND CONTINUES WITH THESE PRACTICES, I
WOULD LIKE THIS MESSAGE, AS DOCUMENTATION FOR POSTERITY, THAT SOME PHARMACIST HAD
WARNED EVERYONE ABOUT THESE DANGEROUS PRACTICES, BUT NO CORRECTIVE ACTIONS WERE
TAKEN…

…AND HE PAID THE ULTIMATE PRICE OF HIS LIFE FIGHTING FOR THIS CAUSE.

SINCERELY,
RAJ BHAT RPh
TAMPA FLORIDA

$137,500,000 is not enough

2010-07-18T13:26:00.002-04:00

In October 2006 Medco settled a suit brought against it by the United States of America. Medco paid $137.5M Insiders and others brought to the attention of our government that things just weren't right at Medco.

The list of charges is long and ugly. Shocking in fact. Re-using returned drugs. Cancelling orders to make bookkeeping appear on schedule. Billing others for Rx's not filled, filled on time, filled correctly.

Medco lost.

The transcript with all the details can be found in the Links section of this blog. If you like horror stories, read the 12 page document.

Medco. You dispense the worlds greatest amount of prescription medicine. You are the largest purchaser of generic drugs in the world. You serve 65,000,000 people (clients).

Medco. Every single prescription you process...each one of them must be right. Stop interfering with your pharmacists judgment to review and approve Rx's.

Fellow pharmacists. You can remain anonymous or go public. But its time to speak out and speak up. Contact me.

-Raj

Send this blog to your FB page - Hit SHARE

2010-07-16T08:16:00.005-04:00

This blog now has a Facebook "share" button.

This blog is updated daily; add yourself as a follower - bottom right corner.

Check the links section if you'd like to read what journalists are reporting about Medco Quota System and related issues. This is updated whenever we discover more news.

Many indie blogs and forums are picking up our story. Students, interns, Rph's and "old-timers" are discussing the IMPOSSIBILITY of safely, correctly, consistently processing ERROR FREE scrips at the rate of 45-55 per hour.

This is Day 12.

Day 10 - Hurry Up and Get Well Soon

2010-07-14T13:21:00.015-04:00

Your prescription is being reviewed one-at-a-time by the pharmacist along with 49 Rx orders, or more, just this very hour.

Your pharmacist works an 8-hour shift today.

Your pharmacist is asked to work overtime too.

He checks your name and address (you may be one of several Mr Smiths in the database of 65,000,000 customers).

He checks your doctors name (there may be more than one Dr Smith in the database of licensed doctors and nurse practionsers in the United States of America who can write an Rx).

He verifies the scribbled handwriting on the scrip as it pops up on his computer screen. He is making sure, exactly sure, of what medicine you are getting; how much; what kind; dosage; how to take it...

This pharmacist sees a discrepancy. Your doc wrote "9" - but it could be "7". Do you mind if he calls the doctor? Of course not. It's your health at stake here.

But there are poor work-performance admonishments ahead for the pharmacist who attaches a digital "sticky note" to your virtual scrip (read: who slows down the process). He knows it. But he cares about Scrip #49 as much as #398 at the end of the day. It could be yours, it really doesn't matter. Your pharmacist is a professional. He follows his Code of Ethics.

The boss says "Hey, hurry up! We've got 1,999,999 more scrips to fill this week!"

The pharmacist say "Yes and we'll fill them correctly because your pharmacists are exercising professional judgment again today."

This pharmacist was fired.
The boss is the largest pharmacy company worldwide.

Hurry up and get well.

True story.
-Raj

Words of Support

2010-07-12T15:04:00.003-04:00

Reprinted with permission from Megan Peters. July 12, 2010. Via Facebook.

Subject: Your story

Hello Raj, it's very nice to meet you. I too work in the retail pharmacy industry and it is sad to see the deterioration in working conditions over time. I am sad to hear about your termination from Medco but I wish you the best of luck in your fight to bring awareness to the important issue of pharmacy workplace conditions. Few people outside the industry are aware of the impact retail business management has had on our profession, and I appreciate your personal sacrifice to make the issue public.

Best of luck to you from across the bay in St Pete,

Megan Peters

Day 7

2010-07-11T15:18:00.000-04:00

This is the 7th day of my hunger strike.

My point is...
My strike is about...
My concern is...

That the 65,000,000 people, and more, who use Medco as their pharmacy get the prescription they need, filled correctly. Absolutely correct. No errors. No mistakes.

I am asking Medco to defend its quota-system policy (pharmacists are expected to fill a minimum number of prescriptions per hour) or stop doing that.

-Raj

Day 6

2010-07-10T09:52:00.003-04:00

This is day six of my hunger strike.

I am strong and I remain patient and confident in my protest. I have gathered friends and strangers who are aware of my cause.

And more information will circulate among the Court of Public Opinion.

I am asking you, the reader to forward this message and build the followers. Join me on FaceBook. Send your comments.

If you are a pharmacist, I would like to hear your professional concerns. Email me at RajBhatTampa@gmail.com

Carry me in your thoughts, the message is that big pharmacys do not have the authority to interfere with a pharmacists Professional Judgment (Florida Pharmacists Code of Ethics). Employers shall not retaliate or terminate an employee for raising workplace concerns (Whistleblower Act).

And the bottom line is that every person must have their prescription filled perfectly, correctly and with the highest standards - their lives depend on it.

-Raj

2010-07-09T17:38:00.004-04:00

My conscience is my god.

I am a patient man.

-Raj

Day 5

2010-07-09T17:22:00.002-04:00

This is day 5.

Doctors scribble. Pharmacists care.

Professional Judgment is mandated by our Code of Ethics; and we have the obligation to exercise it without termination or fear of retaliation.

Within the past years, the pharmacy business has been automated, unpersonalized and put into high gear. Our duty as pharmacists is to assure that a prescription is legitimate and filled correctly.

Doctors scribble. Pharmacists care.

My hunger strike continues.

Without food. Just water.

I am one man who will take the time to tell the story so that this "hurry up" "guess if you must" "we've got 2,000,000 prescriptions to fill this week" attitude will not spill over onto others in the industry. The Medco way is not the best - practise way.

Sincerely,
-Raj

Why Medco "Fill" Practices Constitute an Act of Criminal Negligence

2010-07-08T11:49:00.004-04:00

Since 2005, there have been significant developments concerning pharmacists' liability and accountability for medication errors and in one case a pharmacist has been found criminally liable.

I would like to bring to the attention of one and all the case of an Ohio Pharmacist, Mr. Eric Cropp who was charged with involuntary Manslaughter attributed to a medication error resulting from administration of a sodium chloride solution overdose to child Emily. This fatal error happened in February 2006. Since then, Mr. Cropp lost his Pharmacist license and he was found guilty. Recently he did serve his time in prison. It was obvious that working conditions limited his ability to directly supervise his technician who caused the error. All the same, the court did not accept his defense. If a similar error were to happen at Medco, Medco Pharmacist can not put up a criminal defense that working conditions at Medco did not allow him/her to directly supervise his/her Technician.

In a criminal court of law, a Medco Pharmacist would not be able to put up a defense that he/she committed an error by not clarifying unclear aspects of a prescription because of the Employer's working conditions (threat of disciplinary actions including termination for seeking Doctor Call clarification of unclear prescription).

This Practice of questioning Pharmacists' Judgment at Medco for seeking doctor call clarifications of unclear prescriptions followed by disciplinary actions and threats of termination is undoubtedly an Employer's Act of Criminal Negligence.

This act of Criminal negligence has clearly jeopardized Public Health and Safety.

-Raj

An Open Letter to the Medco Board of Directors

2010-07-07T14:42:00.002-04:00

To the Medco Board of Directors
100 Parsons Pond Drive
Franklin Lakes, NJ 07417

1. Mr. William Roper
2. Mr. Howard W Barker, Jr.
3. Mr. Charles Lillis
4. Mr. David D. Stevens
5. Mr. John L, Cassis
6. Mr. Michael Goldstein
7. Ms. Myrtle Potter
8. Ms. Blenda Wilson

I respectfully appeal to you all to review all the evidence discovered in my legal action against Medco.

It has clearly established Medco Practices of pressuring Pharmacists to enter and check 45-55 prescriptions per hour, giving them slightly over a minute per prescription. It has also clearly established Medco interfering in Pharmacist' professional judgment by disciplining pharmacists and threatening termination for seeking Doctor Call Clarifications in relation to unclear aspects of the prescription.

It has also established Medco lowered the Quality Standards significantly to meet this quota of check rates causing many folds increase in the number of Medication Errors, (thereby jeopardizing public health and safety). The discovery process has substantiated clearly that I was retaliated against via termination for raising these concerns with the Regulatory authorities.

Instead of owning up to the fact that I was terminated because of my reporting to Governmental Agencies, Medco has continued to tarnish my reputation I will not yield to these threats and Medco' s continuing actions of discrediting my name and reputation.

I will carry on my fight till my last breath in defense of the health, safety and life of all the Medco Patients.

These Medco Practices are indefensible by any standard (legal, moral or ethical). instead of stopping these wrongful Practices and undoing the wrong done to me, (by accepting responsibility as a good Corporate Citizen), Medco has continued to defend these Practices.

At this point of time it is only appropriate that Iappeal to you to stop these practices, (as Company Policy) reinstate my Employment and long term benefits thereby undo the damage done to my name and reputation.

As part of your fiduciary duty, it is only appropriate that you take responsibility for these Medco Practices and defend or stop these indefensible practices as you deem fit via a direct explanation to the public at large and Medco share holders.

Thanks,
Raj Bhat
Tampa Florida

Fellow Pharmacists - I want to hear from you

2010-07-06T17:37:00.005-04:00

A Message to Pharmacists

HUNGER STRIKE - DAY TWO

These days, more and more Pharmacists are expressing concerns about the working conditions at different Pharmacy settings.

If these working conditions were better, we know many of the Medication Errors could have been easily prevented.

Many of us are prepared to compromise with our salary remuneration if we can get extra technician hours to improve our working conditions when we work in a Retail Pharmacy.

We are so much caught up in our day-to-day pharmacy routine and our demanding family lives, that we do not get much time to organize to better our work situations.

I have been dealing with Medco situation for the past 8 years, pleading with the Regulators, Senators, and Governors.

At this point of time, I believe we need to have a united effort to organize and address meaningfully concerns related to Pharmacy Practice.

We take our responsibilities very seriously.

According to several studies and opinion polls, pharmacists are considered to be among the most trustworthy and reliable of professionals.

We all need to preserve this trust.

I would like to hear from you all about your work situations and what are the areas we need to focus on, in relation to improving our work conditions and reduce Medication errors.

It is high time we stand up and voice our thoughts. I would like to carry on this fight on behalf of all the Pharmacists to affect the vital changes that need to be done to improve our practice of Pharmacy.

Day Two

2010-07-06T14:53:00.004-04:00

Our story goes out to the media today. It will be linked to my Facebook page too.

I am a pharmacist with a conscience*.

Today is the second day of my hunger strike to bring awareness about Medco's prescription filling policies.

-Raj

*motivation deriving logically from ethical or moral principles that govern a person's thoughts and actions

Day One

2010-07-05T23:43:00.003-04:00

Thinking about Medco.

I have tried in so many ways to speak with them.

My recent letter to Medco CEO Mr. David Snow has gone unanswered by him...by anyone.

This is my appeal to the conscience of the American people at large, Public Interest/Advocacy groups, members of the Legal Profession, Judiciary, Legislature, Rating Agencies like JCAHO, Regulatory Agencies, Boards of Pharmacy (Florida and other states), US Senate Finance Committee, Medco Board of Directors, Medco shareholders and the members of the press.

This is also my appeal to the conscience of Legislators and Lobbyists who knowingly do corporate bidding and compromise Public Interest and Safety.

The practice of questioning Pharmacists' judgment at Medco followed by disciplinary actions and threats of termination is undoubtedly an Employer's Act of Criminal Negligence. This act of Criminal negligence has clearly jeopardized Public Health and Safety.

-Raj

Hunger Strike against Medco

2010-07-05T15:01:00.001-04:00

July 5, 2010. I will not take food. This is a hunger strike.

I am bringing a story to the Court of Public Opinion.

The story is about Medco; the worlds largest purchaser of generic drugs; the worlds biggest pharmacy company. Traded on the NYSE, Medco had $59B in net revenue (2009). It employs 23,000 people of which about 3000 are pharmacists.

I worked at Medco from 1995-2005.

My issue?

To bring public awareness about the high-speed computerized mail-order pharmacy practices at Medco Tampa. Specifically that those internet pharmacists are expected to review, approve and database up to 50 prescriptions per hour. All work is done via computer screen. Working an 8-hour shift, this means a pharmacist might process 400 orders per day. No errors are tolerable, but they are inevitable and happen at a recorded corporate-wide weekly rate ranging from 300 per million to 100 per million (2005) and up from 30 per million (2003).

What am I asking?

1. Allow pharmacist sufficient, adequate time per transaction to use Professional Judgment as needed. Do this without penalizing, criticizing or humiliating your professional pharmacist staff.

2. Support without bias, the unimpeded option to refer un-clear and/or scribbled prescriptions to “Call Doctor” system. Referrals are not a slow-down; nor are they a reduction in patient care. Pharmacists have a professional duty to get it right every time. Guessing the doctors handwriting is not an option.

What is Professional Judgment?
adequate, thoughtful time to: read scribbled prescriptions fact-check prescription for doctor authenticity fact-check prescriber for proper licensure verify prescription accuracy, dosage, instructions

There is more to know.

But know one thing... if YOU got a bad prescription - this issue will matter.
If you don't get an erroneous prescription, it is because a pharmacist has correctly, thoughtfully and professionally read your doctors' orders and filled the prescription accurately and advised you properly.

This hunger strike is about you.
Raj