Pharmacist's Hunger Strike Over Medco Rx Errors: 75 Days and Counting

Raj Bhat, a former Medco (MHS) pharmacist, is now in the 75th day of his hunger strike against what he claims is the company's policy of requiring its pharmacists to fill prescriptions at a rate of 50 or more per hour. He's now too weak to continue his blog, and is in the process of writing his "Final Message" before his friends and family take over daily posting duties. He just might die before Medco gives in to his demand to recognize that such a high work rate leads to medication errors for patients.

Medco says Bhat's claims are without merit and that he was fired for subpar performance. No matter how you look at this, it's one of the more unusual news stories in the pharmaceutical business right now. I interviewed him this morning. He spoke very softly and sounded physically weak, although he remains voluble about his cause.

BNET: It's been 75 days. How do you feel?
BHAT: I feel weak in the legs and I don't have much strength and my voice has gone but mentally I feel good, I feel OK. I have to conserve as much energy as possible. I have to cut down my physical activity.

BNET: Are you eating any food or water?
BHAT: I'm taking salt and and water and also calcium. I have some shortness of breath from time to time so I started taking some iron tablets also.

BNET: Has there been any response from Medco?
BHAT: Not directly from them but ... the U.S. steel workers union [which represents Medco staff] also came out with the same kind of allegations against Medco ... They also mention the same things, unreasonable production requirements which is actually a quota. They also mention that if a pharmacist cannot read or decipher a prescription he has to call the doctor and Medco doesn't like it. The union also has also realized its a public safety issue because Medco has been pushing the envelope to extremes. Now they're getting the prescriptions entered by technicians and now they're pushing their goal up. I've learned reliably their goal now for pharmacists is 70 prescriptions per hour, and pharmacists are given a target of 130 to 150 prescriptions per hour from the prescriptions entered by technicians. At this rate they cannot even check the prescriptions following Medco's own SOP [standard operating procedure]. If someone tries to judge what is reasonable, this 130 to 150 prescription rate is very clearly ridiculous ... it means more errors are committed.

BNET: Aren't you at risk of starving to death?
BHAT: Actually I have no idea because I have not seen the doctor. The way I feel, if I get dehydrated I take salt and water but i have not made any research on how long a person can live on water and salt. But if I conserve my energy i can handle this but it is not my intention to die for this cause ... but it's a matter of conscience. It's a public safety issue ... it's a possibility but I'm fighting this with the mindset of a soldier. When you sign up to fight a battle you have to focus on the job at hand. I'm thinking about these things positively.

BNET: How much support have you received?
BHAT: There is a good deal of support in the sense that now the U.S. steel workers union sent me a letter asking me to trust the collective power of the union to help solve this issue.

BNET: Medco has said this about your protest:

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 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 judgement. Mr. Bhat's termination was based solely on poor performance and his failure to raise performance levels to acceptable standards â€"- despite repeated warnings.

BHAT: That is all false. The ethics department was headed by Michael Clarke, a company attorney. It's not an independent ethics department. The reason they gave me was I was seeking doctor-call clarification. If the prescription they gave me was scribbled we have an obligation to seek doctor-calls to clarify. All those doctor-call clarifications were very valid. I was the only one who was fired for reasons of poor performance. It's damaged my reputation also because they asked for documents from employers I worked for after I left Medco. That created a bad reputation for me in the industry. I had given 100 percent to that company. I was there for 10 years.

BNET: What does your family say about all this?
BHAT: My wife knows all these details. They actually believe in the whole thing. They are concerned about my health no doubt, but they know I'm doing it to safeguard the interests of the family as well but its also a moral question. We believe in doing the right actions. If I walked away it is the wrong action on that. We have a responsibility to society.

BNET: What do you mean by "Final Message"?
BHAT: From that time onwards there is nothing more I will be putting up. I'm a little bit concerned about my health. It's more than 70 days now. For the last one month or so I was working on that final message because I have to space myself out. I have refused any kind of medical intervention or hospitalization if anything happens to me. Not that I'm intending to die for this cause, but if they're not held accountable ... only daily updates from family members will happen on the blog. This issue is not just mine. Many a time the patient doesn't know they got the wrong medication so they are banking on the innocence of patients.

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Image by Flickr user Sister 72, CC.

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