Thursday, February 6, 2014

CVS pharmacies to halt tobacco sales

[I]ndustry experts say the strategy shift is less an altruistic endeavor than a savvy marketing ploy from a drugstore giant trying to promote itself as a retail health hub in an age of increasingly self-serve healthcare.

...Amid a shortage of primary care doctors and legislation that expands access to healthcare coverage, CVS and many of its competitors are investing in more in-store urgent care clinics. They're also featuring pharmacists who can offer medical counseling and extending outreach efforts to clinicians and medical centers."

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We've seen for a while the option of getting flu or shingles vaccines from pharmacies. I think it's a logical step forward, and will help streamline the medical process. 

Has anyone here gotten the shingles vaccine? Shingles are very painful, and "usually appears in a band, a strip, or a small area on one side of the face or body."  If you had chicken pox as a child, left over viruses can hide in the nerves:

"Shingles occurs when the virus that causes chickenpox starts up again in your body. After you get better from chickenpox, the virus "sleeps" (is dormant) in your nerve roots. In some people, it stays dormant forever. In others, the virus "wakes up" when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus to wake up and cause a shingles rash. It is not clear why this happens. But after the virus becomes active again, it can only cause shingles, not chickenpox.

You can't catch shingles from someone else who has shingles. But there is a small chance that a person with a shingles rash can spread the virus to another person who hasn't had chickenpox and who hasn't gotten the chickenpox vaccine."

38 comments:

lohwoman said...

My husband and I got the vaccine a couple of years ago. The disclaimer said it works 50 percent of the time. I'm hoping for the best.

Michael Haz said...

As I write this, Mrs. Haz is preparing to drive to a hospice where she will say good-bye to a colleague of 25 years who is dying of lung cancer that metasized to brain and liver.

The colleague is a lovely woman in her late forties who was full of vitality and laughter until the cancer was discovered last year. Like many others who contract cancer, she will be gone far too early in life.

I don't know anything about CVS's motives or business strategy in stopping the sale of cigarettes from its stores. I applaud their decision.

Cigarette smoking causes lung cancer, period. Eighty-six percent of lung cancer deaths are cigarette smokers. Cigarette smoking is also the leading cause of coronary heart disease, including sudden death due to heart failure.

CVS is doing the right thing.

AllenS said...

The problem for me is I'm not sure if I've had chicken pox.

AllenS said...

Around here, people who smoke, buy their tobacco at tobacco stores, then roll their own. A lot of people around here smoke.

sakredkow said...

I applaud CVS too. They're a corporate entity, they can make their own decisions and this is a good one.

There's no point in using tobacco the way we use it. It just weakens us.

edutcher said...

The Blonde has been on my case for a while to get the shingles shot (mostly, I think just to stick a needle in me).

Got it about a month ago.

No big whoop.

Palladian said...

This makes me crave a good cigarette.

john said...

There's a story about a Las Vegas woman who took a cab to the drugstore to pick up her antianxiety meds prescribed for her gambling addiction. She was also on oxygen. And the drug store has slot machines.

Several hours later, flat broke, credit depleted, she hadn't picked up her meds nor could she get up from the machine because her oxygen tank was empty and there was no money to refill it.

Lesson: Other drug stores in the area offer free oxygen to their customers as long as they have a positive gambling credit balance. I am sure it is better for business not to have dead people slumped over those profitable machines.

From "Addiction by Design", a very good yet disturbing book about machine gambling.

chickelit said...

I had the chicken pox and every form of measles available, as a kid. I never had the mumps though.

Eric the Fruit Bat said...

Mrs. Haz is a better person than me.

Eric the Fruit Bat said...

I had a friend in high school whose parents owned a small deli and they sold cigarettes to minors.

I complained to my friend that it was illegal and wrong and I said they shouldn't do it.

He said, "If we don't sell it to them then someone else will."

To that I had no comeback. He was right.

I should add that neither of his parents smoked, nor did he.

Aridog said...

Michael Haz said...

... dying of lung cancer that metasized to brain and liver.

Every day I am reminded of just how lucky I am. 71 years old. Smoked 2-3 packs a day, Camels or Winstons, for 55+ years. Lung cancer hit in 2012. I survived and am still clear. Shit luck. Nothing else. Last X-ray was last week. Next CT Scan is next week. So far zero cancer return. Going on 2 years. Lucky MF'R am I.

phx said...

There's no point in using tobacco the way we use it.

Palladian said...

This makes me crave a good cigarette.

I still crave a cigarette, every day, all day. I truly loved and enjoyed smoking. Period. But I won't smoke one. Won't shoot myself in the head either. Same thing.



sakredkow said...

I still crave a cigarette, every day, all day. I truly loved and enjoyed smoking. Period. But I won't smoke one. Won't shoot myself in the head either. Same thing.

Me, too. Wish I hadn't wasted all that time smoking to begin with! That's why I think it's a good thing if it's harder for young people to pick it up. Why should they bother?

Christy said...

Dad had an unpleasant time with shingles, but my cousin was just devastated by them. She was briefly in the hospital and they lasted for about a year. Everybody said it was stress induced. Something about a mother-in-law ....

I've been an anti-smoking Nazi from when I was old enough to talk and demand my parents roll down the car windows. We thought my 86 year old mom had finally developed cancer this year when an x-Ray caught a spot, but the biopsy was clean. The anesthesia for the biopsy also shortened her memory from 5 minutes to 45 seconds.

ndspinelli said...

Haz, You're a good friend. I got the shingles vaccine when I turned 60. It's expensive and that's when my insurance would pay for it.

MamaM said...

Cashiers at Walgreens now end their check out transactions with the directive: Be Well!

That Walgreens couldn't get their computer to stop filling my original request for 30 of a 120 pill prescription (to determine body response), and continued to randomly default to filling 30 following computer and phone requests for the 120 prescribed, which required a face to face discussion which cheerfully yielded the 120 needed while supposedly canceling the aberrant request for 30, only to later discover via a phone call from the prescribing doctor's office that a request for refill message has been sent, which was subsequently approved (without my input) for 3 refills with an office visit required for more, when 9 refills were left on the original script; well, well, well, well...what I can I say other than I wish they'd be well and take care of themselves too.

Trooper York said...

This is the face of Obamacare. Where you can't go to a doctor but instead go to your pharmacist for medical care.

Urgent care store front bodegas have sprung up all over Brooklyn. You can not find a personal doctor anymore. Either they don't take any new patients or became concierge doctors who charge a big upfront fee or they are quacks that you don't want as a doctor. These urgent care storefronts operate as a sort of private emergency room. The days of you having your own private doctor who knew your history is rapidly coming to an end.

Eric the Fruit Bat said...

It's very old news that fewer and fewer med students want to hang a shingle and practice general medicine.

Can't say I blame 'em.

Eric the Fruit Bat said...

I still crave a cigarette, every day, all day.

That made me think that I misinterpreted Palladian's comment, which I took to be a proclamation of rebelliousness, not vulnerability.

JAL said...

Had chicken pox.

Had a very very mild case of shingles a couple years ago? (Self diagnosed after a "What the heck is this?" discovery. Confirmed by dr. daughter from an iPhone pix.)

Haven't had the shingles shot. Have associated it with lowered immune system and stress in pts. I had when I worked in hospital.

Palladian said...

It was vulnerable rebelliousness, Mr Fruit Bat.

Revenant said...

This is the face of Obamacare. Where you can't go to a doctor but instead go to your pharmacist for medical care.

If so then it is the first face of ObamaCare I'm NOT unhappy to see.

Doctors have a government-enforced monopoly on health care, including health care that any trained monkey is capable of performing. Anything that can be done to weaken that monopoly is a win for consumers.

Palladian said...

Anything, Revenant? It seems like the creation of a massive, intrusive, economically ruinous government health care apparatus and an astronomical increase in governmental monopoly over medical care is surely not a 'win' for consumers.

Trooper York said...

Have you ever dealt with a pharmacist from CVS?

My pharmacist is a tiny little girl from Korea with a language issue. I would trust her with a recipe for Poodle Stew but I don't know if I would trust her to diagnose my ailments.

I recently misdiagnosed by a full fledged Doctor. He told me I had an allergy when I had congestive heart failure. I certainly don't want to rely on a pill pusher to tell me I have strep or something.

sakredkow said...

I recently misdiagnosed by a full fledged Doctor. He told me I had an allergy when I had congestive heart failure. I certainly don't want to rely on a pill pusher to tell me I have strep or something.

For sure. If you're going to be misdiagnosed might as well be misdiagnosed by someone who has the degree to back up her misdiagnosis.

Revenant said...

It seems like the creation of a massive, intrusive, economically ruinous government health care apparatus and an astronomical increase in governmental monopoly over medical care is surely not a 'win' for consumers.

Would you like to explain why you think the above weakens doctors' monopoly on health care?

Because if it doesn't, then it isn't a valid response to my comment.

Revenant said...

recently misdiagnosed by a full fledged Doctor. He told me I had an allergy when I had congestive heart failure. I certainly don't want to rely on a pill pusher to tell me I have strep or something

"A doctor misdiagnosed me and put my life at risk. Therefore, we should rely exclusively on doctors".

Not sure I follow your line of reasoning there, dude.

Look, there's no mystery to this: you never expect quality from a monopoly. No competition = no incentive to improve. This is particularly true when overall demand is high enough that the individual members of the monopoly can be guaranteed business no matter how much they suck.

The Dude said...

I paid 170 bucks for my anti-shingles shot.

Vinyl siding would have been less expensive.

Trooper York said...

The point is that doctors are fucked up and half the time they don't know what they are doing. Why would I go to someone who knows a lot less but knows how much Depends or Kotex costs and if it is on sale that week.

Doctors suck but pharmacists will be even worse.

Trooper York said...

There is some torturous logic in there if you search for it. Just sayn'

Eric the Fruit Bat said...

It's like abstract expressionism, except it's supposed to be something else.

deborah said...

from the article:
" CVS and many of its competitors are investing in more in-store urgent care clinics. They're also featuring pharmacists who can offer medical counseling and extending outreach efforts to clinicians and medical centers.""

The urgent care part would not be manned by the pharmacist, but probably a nurse practioner who could give you an instant read strep test or flu medicine, etc.

deborah said...

I agree with Rev, in that it's a pain to go though setting up an appointment and seeing the pediatrician, when you can just walk into a pharmacy.

The total bitch of it all is the shortages of doctors, physician's assistants, and nurse practioners. Things are going to be very hairy for the next 20 years.

Icepick said...


Vinyl siding would have been less expensive.


Expect to see the vinyl version of Sixty Grit very, very soon. But probably not in stores near you.

Icepick said...

The total bitch of it all is the shortages of doctors, physician's assistants, and nurse practioners. Things are going to be very hairy for the next 20 years.

Yeah, but now that they've increased the amount of demand by about 30,000,000 customers (if they succeed), things should get much better now! Plus they want to increase the amount of Third World peasants in the country by twenty to thirty million people in the coming years, so that should ALSO help!

Uh, wait, maybe I've got that backwards?

Dust Bunny Queen said...

CVS is making a decision based on their own principles. I agree with them, in that smoking is a horrible addiction. I never started for the reason that I saw my mother struggling to quit all the time. If SHE couldn't stop, being a very strong willed woman, I sure as Hell wasn't going to start. Never smoked a day in my life Well...cigarettes anyway :-) But, I'm not going to go around telling other people what to do either.

My husband had a bad case of shingles when he was going through a nasty divorce. Stress caused. It was, to hear him tell, very very painful and stretched around his waist from one side on the back to the other. To this day, when I put my hands on that area it is often icy cold or burning hot. Not normal skin temperature.

As a kid in the 50's we had all the routine diseases. Bad case of chicken pox that has left scars on my arms and legs. My mother had to put my arms and legs inside of oatmeal boxes (rounds) to keep my arms and legs from bending, socks on my hands and feet to keep from scratching. I was delirious with a high temperature. Measles and mumps of course. Thankfully, we didn't get Polio as many children in our age group and geographic location did. All these diseases were just considered normal rites of passage as children.

People who don't vaccinate their children are idiots and child abusers.

Bleach Drinkers Curing Coronavirus Together said...

My pharmacist is a tiny little girl from Korea with a language issue. I would trust her with a recipe for Poodle Stew but I don't know if I would trust her to diagnose my ailments.

You know, you can choose which pharmacist/pharmacy you can go to even more easily than you can your physician. It's harder to find someone who gives a damn now though because the big chains bought the independents out. That's why they're now trying to bring some of that sort back in. And what Deb says about the staffing by mid-level practitioners is true. They'd be seeing you at most offices anyway. If they take over for the FACT that most ER admissions ARE for the non-traumatic and not-so-acute issues that the midlevels can do, then there's no reason why they shouldn't do it outside a busy ER. And they've (drugstores) been onto expanding this model way before Obama got into office.

Also, Deb, their numbers will be fine to handle any shortage. Either the medical education cartel will expand the supply, or the midlevels will fill the gap. It doesn't matter either way.

And second opinions are a fact of life. I have no evidence that they occur less with physicians than with midlevels, but I can understand why people would fear that. Still doesn't stop physician practices from hiring them in droves and having the AMA endorse and define their use.

It's unfortunate when a misdiagnosis should result in something as serious as confusing CHF for an allergy, but it's sort of crazy that any appointment with those symptoms wouldn't have revealed underlying cardiac disease. Yes, there are quacks out there. If nothing was revealed on a cardiac exam then they could have checked for leg swelling. If the symptoms tend to overlap enough, they consider both conditions to be on the same "differential" and should check them against each other to make sure they're not ruling anything out or in that they shouldn't be.

Michael Haz said...

The internet is a wonderful thing. Spend a few minutes typing in your symptoms and the internet will suggest some possible illnesses and diseases your symptoms may indicate.

Then visit your MD with that information in hand. Don't joke around with your MD, don't over or understate your symptoms. If you are not comfortable with your MD, find a different one. Every hospital has a service that helps people find MDs.

Patient and doctor are both responsible for the patient's healthcare.