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Pharmacists Mutual Expands Services to Puerto Rico

Tuesday, December 29 2015 Submitted by Pharmacists Mutual

News Release – December 29, 2015

For more information contact Shelly Brown at 515.395.7235 or shelly.brown@phmic.com.

Pharmacists Mutual expands services to Puerto Rico

Pharmacists Mutual Insurance Company, a nationally recognized leader in providing insurance products and risk management solutions for pharmacists and associated businesses and professionals, is excited to begin offering services in Puerto Rico. The company has contracted with Caribe Professional Insurance Agency in San Juan; Caribe will solicit and sell insurance products and services on behalf of Pharmacists Mutual in Puerto Rico. Offerings will include business insurance coverage and professional liability, as well as risk management solutions.

Founded in 1909 by pharmacist Al Falkenhainer, Pharmacists Mutual is an A (Excellent) rated property and casualty niche market insurer, dedicated to providing peace of mind through specialized insurance solutions and superior personal service. Pharmacists Mutual operates in all 50 states, is endorsed by 41 state pharmacy associations and has partnerships with several national organizations.

For more information, visit www.phmic.com or call 800.247.5930.

Veterans Day

Wednesday, November 11 2015 Submitted by Pharmacists Mutual

November 11, the day hostilities ended in 1918 following years of war, was first recognized by President Wilson in 1919 to commemorate Armistice Day. He offered these words:

“To us in America, the reflections of Armistice Day will be filled with solemn pride in the heroism of those who died in the country’s service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations…”

Later in 1926, the U.S. Congress recognized the end of World War 1 by passing a resolution that requested that President Coolidge invite “the people of the United States to observe the day in schools and churches, or other suitable places, with appropriate ceremonies of friendly relations with all other peoples.”

Congress then moved in 1938 to establish November 11 as a legal holiday known as Armistice Day to honor veterans of World War 1. In 1954, the name of the day was changed to Veterans Day in order to honor veterans of all wars.

Honoring our fellow Americans who sacrificed so much, often including their lives, is fitting and proper. The debt we owe to these brave men and women can never be repaid, nor can those of us who have not served truly understand the horror of war. To my late grandfather (WWI) and uncle (WW2) and my living brother-in-law (Iraq) and best friend (Afghanistan), I can only bow my head and give thanks. To my fellow coworkers who have also served our great nation, I also offer my sincere gratitude and admiration. Please join me in honoring these true heroes on this special day.

Edward J. Yorty, FCAS, FSA, MAAA, M.S. Fin | President and CEO
Pharmacists Mutual Companies

Importance of Immunizations

Monday, October 19 2015 Submitted by Pharmacists Mutual

Importance of Immunizations

Kristen Jones, PharmD, Risk Management Consultant

As the school year is here and holidays are approaching, take some time to review your child’s immunization record.  Do you have a record?  Is it up to date?  In light of the measles outbreak last December, reviewing this information and catching up missing vaccinations can prevent serious illness for your child, family and community.  Preventing diseases is often times much easier than treating the disease itself.

Vaccines work by exposing the body to a small amount of the disease causing antigen which is usually weakened or dead.  This allows the immune system to develop antibodies to those antigens.  Consequently, if the disease enters the body again, the immune system already has a response.  This protection is called immunity.

Vaccines work best when most members of a community are vaccinated – the more people who are vaccinated, the lower the possible risk of anyone’s exposure to vaccine-preventable diseases.  This is known as herd immunity. Because the disease cannot be passed among a large group of immunized people, those individuals who cannot receive vaccinations, mostly infants and immunocompromised patients, are protected.

Myths and misinformation about vaccine safety can confuse parents who are trying to make sound decisions about their children’s health care. Some sickness or reactions are associated with the vaccination, but many times these events occur in coincidence with the administration of the vaccine. Because vaccines must be safe for use by as many people as possible, vaccines are developed in accordance with the highest standards of safety with years of testing before distribution.  Ongoing testing and reporting is done on all vaccines administered in the United States.


Take some time to review your child’s immunization record and update as needed. If you have hesitations about immunizations, talk to your doctor and make informed decisions.  If your concern is too many shots at once, often providers will help develop a schedule you feel more comfortable with.  They can also help kids get caught up who may be behind.  For more information including immunization schedules please visit http://www.cdc.gov.


Pharmacy Crime – Still a threat

Thursday, October 1 2015 Submitted by Pharmacists Mutual

Pharmacy Crime – Still a threat
Michael L. Warren, ARM, OHST, Risk Manager

Despite extensive efforts to control the available supply of narcotics through Prescription Drug Monitoring Programs, rescheduling, education, drug disposal programs and other measures, rates of addiction fueling demand have not been significantly reduced. In its annual Behavioral Health Barometer for 2104, SAMHSA (Substance Abuse and Mental Health Services Administration), the number of U.S. adults over 12 years or older with drug dependence or abuse was 6.9 million, but only 13.4% received treatment. The National Institutes of Health Institute on Drug Abuse estimates that 2.4 million Americans, or 6,600 a day, used prescription drugs without a medical need for the first time this past year. In a country that consumes 99% of the worlds supply of hydrocodone and 71% of oxycodone in the past year, these numbers are not surprising.

While supply side economics supports the idea that cutting supply and increasing price will reduce demand, the rules don’t work in the world of prescription drug addiction. While measures have been taken to control how drugs flow through the system to the end user, the fact is that because narcotics are prescribed legitimately they are still available in most pharmacies across the country. Addicts, abusers and those that sell them illegally know this, and know that a pharmacy theft can easy and profitable against the right target.

So what is the wrong target for a thief? One that is hardened against pharmacy theft. Where the criminal is unable to get what they want in under 2 minutes, the average time for a pharmacy theft. Where uncertainty comes from the protective measures they see and the evidence they gather when scoping out a prospective target that the pharmacy staff is aware.

For the pharmacist, it is a balance between finding the right amount of protection to meet the specific threat against their store. Knowing what kinds of measures to take and how to prioritize protection levels requires an understanding of the threat.

To help our member companies, Pharmacists Mutual provides threat assessment and crime prevention tools, as well as consulting services that were developed based on years of research into pharmacy crime trends, methods criminals use and successful ways to prevent or limit the size of potential pharmacy threats.

Over the next year, Pharmacists Mutual will be sharing what we have learned over the years about how criminals strike, tools and techniques available to the pharmacist to control the problem and ways to help prioritize protection levels. Look for us on Facebook, Twitter, Linked In and in print.

If you have questions about security in your pharmacy and would like to speak with a risk management professional, please contact us at loss.control@phmic.com.

What Do Pharmacists Do When the Unthinkable Happens?

Tuesday, September 2 2014 Submitted by Pharmacists Mutual

By Ken Baker, R.Ph., J.D.
Consultant for Pharmacists Mutual Insurance Co.

Every pharmacist knows they can and do make mistakes. If we have a good prescription system, we can usually catch the mistake before it reaches the patient. Eventually, if we practice long enough, one of these near misses reaches a patient and it becomes every pharmacists’ worst nightmare. What happens at that point is often a question of luck.

The patient may notice the mistake and return the prescription to the pharmacy before any of the drug is taken.

The patient may take the medication, but no harm results. For example, a prescription for an otic is mistakenly filled with an ophthalmic form of the drug. A medication error was made, but no one was injured, the patient probably got well and neither the pharmacist nor the patient ever knows a mistake was made.[1]

Too often, however, the patient takes the incorrect medication and notices the mistake only afterwards. How does the pharmacist handle the situation when a patient returns to the pharmacy alleging that the pharmacy made an error? What evidence does the pharmacist need to preserve? What can be said and what should not be said?

A conversation may seem very cordial and end on a good note. Most times the feeling that “everything went well” proves to be correct and the matter is over. Occasionally, however, the patient receives advice from other parties and the friendly exchange escalates into a claim and/or a lawsuit. The problem is you can never be certain what the future will hold, so you should document as if there will be a reason to be able to recall exactly what was said and done. Consider a few sample procedures to follow whenever an incident happens that could lead to a professional liability claim.

Protect your patient.

The first rule is take care of the patient. Whether your pharmacy made a mistake – or someone else did – your patient has a potential problem. They are probably concerned and anxious. There could be worse injuries if treatment is delayed. Find out if the patient took any of the wrong medication or if they missed any prescribed medication. Make certain they get any necessary medical help. Not only may this mitigate damages caused by the error, more importantly, your patient may need to receive treatment. Whether or not they need care is probably not your decision, but the patient’s and the prescriber’s. Even if there is no apparent injury, you need to call the prescriber so the information can be placed in the patient’s file. In McClure v. WALGREEN, the Iowa Supreme Court criticized the pharmacy for failing to warn the patient of the potential effects of the error when its employees discovered the mistake and used this failure as one of the bases of additional damages.

Ask questions.

Once all emergencies have been handled, try to find the extent of any potential problems by asking questions. Did the patient take any of the erroneous prescription medication? If so, how much did they take? When did they take it? Document the conversations with the patient or caregiver. If what was said is ever needed, any trial or deposition may be 2-3 years or later in the future. Under court rules, you can use your notes to refresh your recollection. All documentation must be truthful and accurate as your credibility will be on trial as well as the case. If possible, have a witness to the conversation initial the notes. In addition, you should retrieve any incorrect prescription to prevent any additional harm – but do not destroy it. Count the tablets and save the bottle. Treat this as evidence by placing it in an envelope and sealing it with your initials on the closure. The best place to document is on the back of the prescription, on paper stapled to the prescription or in a file folder, as long it’s easy to find later. Notes in the computer can be lost and hand written notes are more easily authenticated. Pharmacists Mutual has a documentation journal available for this purpose. You can get one or more from your Pharmacists Mutual representative or by calling the company and asking for the Pharmacists Journal.

Do not admit liability.

If you make an obvious error, you may say, “I made a mistake, I am sorry.” You may not, however, admit liability or offer to pay money or to settle the case using your own money, as one pharmacist did under pressure from an angry customer. Admitting liability is more than saying “I made a mistake.” A mistake, such as putting the wrong drug in the bottle, is a fact question. Admitting liability, such as saying “I caused your injuries,” is a legal statement. Not only would admitting liability be a possible violation of the conditions in your insurance policy, but would also probably be beyond your knowledge. The patient may have other conditions or other incidents of which you are not aware.

Show compassion.

If the error is not obvious to you or if you think you are not responsible for the mistake, you should not argue the point with the patient, but you can express sympathy for the patient. You can always say, “I’m sorry you feel bad.”

Act quickly.

When any mistake is made that could result in a claim, immediately report it to your insurance company. Your policy may have penalties for not reporting promptly.

Train your staff.

Finally, train your staff how to react if the “unthinkable” happens. A question like “Why is this tablet a different color?” should be a pharmacist only question. The pharmacist should treat every such question as an error unless and until the opposite is PROVED.

This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorney and insurance company for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly. Names used in this article have been changed and any similarity to real persons is purely coincidental.

[1] In a study at Pharmacists Mutual over a three-year study, 2% of all claims filed against pharmacists involved a prescription for an ophthalmic filled with the otic form. Never in the past 15 years, however has Pharmacist Mutual received a claim for an ophthalmic drop mistakenly given for a prescribed otic.

Finding Support During a Stressful Claims Experience

Thursday, April 17 2014 Submitted by Pharmacists Mutual

Insurance claims can cause feelings of loss, guilt, fear & frustration.

According to the Institute of Medicine, at least 1.5 million Americans suffer from preventable adverse effects due to improper use of their medications each year. That has contributed to unprecedented litigation and discipline throughout the health care industry. The National Practitioner Data Bank (NPDB) cites 565,787 counts of medical malpractice and adverse action reports from 2002-2012 – with pharmacy representing 18,737 cases.

This can be costly for business. Even though overall payment amounts decreased in 2012, there were still a total of 12,142 medical malpractice payouts – or roughly 1 payout every 43 minutes.

In short, a medical malpractice charge can happen to anyone at any time.

Professional liability and umbrella coverage can help you protect your business and financial assets. But what about the mental and emotional tolls a liability claim can take on the practitioner?

“A stressful claim or lawsuit can cause an insured to experience feelings of shame, guilt, anger and frustration. We feel that by allowing our insureds to confidentially share those feelings with a peer who has been through a similar situation, they can regain a sense of control, allowing them to function as a good defendant and a competent pharmacist during the claim process,” says Wendy L. Guthrie, Manager – Professional Liability Claims for Pharmacists Mutual.

The Pharmacists Mutual Peace of Mind Peer Support Program is a confidential, complimentary service available for our members who are experiencing or have experienced a professional liability claim.

We understand the traumatic impact a claim – particularly one alleging professional negligence – may have on your professional and personal well-being. You may feel a mix of emotions, including regret, grief, disappointment, resentment, even helplessness.

“A stressful claim or lawsuit can cause an insured to experience feelings of shame, guilt, anger and frustration.”

We’re here to help. We offer a peer support program to connect you with others who have been through a similar situation. The program is completely confidential and discreet; peers are partnered together to allow for informal conversation and emotional support, not to discuss the details or legal merits of the case.

The goal of this program is to diminish the effects of stress during the claims process, allowing you, as a professional, to regain a sense of emotional balance and control. This also enables you to function as a credible defendant and a competent practitioner during the claim or litigation process.

At some point, even the most experienced pharmacist may face a liability charge. You don’t have to go it alone.

If you or someone you know can benefit from the Peace of Mind Peer Support Program, or if you would like further information, please contact Pharmacists Mutual at 800.247.5930 ext. 4280 or email peer.support@phmic.com

Looking for ways you can help prevent a claim from happening? Check out our Risk Management Intel publications. They are filled with preventative tips, safety protocols, checklists, guidelines and much more.

Making Social Media Work for Your Business

Wednesday, November 6 2013 Submitted by Pharmacists Mutual

Social Media for Health Care ProfessionalsTwitter, Facebook, Tumblr – you may have used these platforms for keeping up with family and friends, following your favorite brands or tracking activities in the community. But have you considered the value social media can add to your business?

Today social media is more than just a way to keep people connected. It’s a highly cost-effective and easily implemented method for reaching customers – from authoring blogs on WordPress to tweeting quick tips on Twitter to sharing video on YouTube, Vine and Instagram.

What value could a social media plan have for your business? Here are a few roles social media can play:

  • Demonstrate your expertise. Bring the same level of trust your patients have in you to social media. Give advice, provide insights and share relevant content from your favorite websites.
  • Show your personality. Post behind-the-scenes photos, office happenings or words of wisdom that make you unique.
  • Connect with your patients. Ask questions and respond to their inquiries via social media channels. Social media can also be a first place to address customer service concerns.
  • Increase exposure. Each “share” or “retweet” means your name could appear in front of potential customers.
  • Improve your SEO. With each social media account, you can set up a link back to your website. The more social media profiles you have, the more opportunities for you to “own” the results on a Google search for your business.
  • Stay informed. Keep up with your peers by monitoring online conversations on industry trends or pending legislation. You may also find out what people are saying about you and your business.

Some specific tactics you may be able to apply to social media for your business:

  • Use Instagram to show equipment or office features from unique angles. For pharmacists, this may showcase the advanced services or specialized practices utilized in your pharmacy. For our dental customers, explaining what each piece of equipment does may alleviate some of the intimidation that comes from an office visit.
  • Connect with partners and vendors on LinkedIn – which is also a great place for recruiting. Share industry articles you might read online.
  • Ask fun, engaging questions on Twitter or Facebook (for example: “How much does the tooth fairy leave at your house?” or “What’s your child’s favorite flavor when they need an antibiotic?”).
  • Post patient testimonials on YouTube or Instagram.

These are just a few ideas. Check out these other great resources specifically related to social media for dental practices and pharmacies.

Are you active on social media? What have you found to be the most effective? Leave your thoughts in the comments below.

The Opioid Epidemic

Tuesday, July 23 2013 Submitted by Pharmacists Mutual

There is a persistent and growing problem in the pharmacy industry – the proliferation of opioid use and the negative downstream effects that impact healthcare outcomes and cost millions of dollars annually.

Opioids fill legitimate pain treatment needs when prescribed and dispensed responsibly. Unfortunately, for a variety of reasons, use and diversion have exploded into what is described by the Centers for Disease Control as a national epidemic. According to the 2010 National Survey on Drug Use and Health conducted by the US Department of Health and Human Services:

  • 5.1 million people use opioid pain medications in any given month.
  • Narcotic analgesics exceeded 238 million prescriptions in 2010 (nearly 2 prescriptions for every 3 residents of the U.S.)
  • Deaths from opioid analgesics now exceed deaths from both suicide and motor vehicle collisions annually.
  • More people die from opioids, the synthetic form of opiates, than from heroin and cocaine use combined.

Opioid Risk Management Newsletter

What does this mean for you? Millions of dollars in direct or indirect costs associated with the cost of pharmacy burglaries and robberies, costs to protect against theft, prescription fraud, professional liability associated with filling prescriptions, and increased workers compensation claims when employees are injured. Additional costs that can be more difficult to calculate include time spent dealing with police, the board of pharmacy, the DEA and lost business.

In a special edition of our Risk Management Newsletter, our expert risk management team explores the fundamental causes of the problem, how it adversely impacts business results, and what can be done to turn the tide. Pharmacists Mutual provides specialized insurance products for our members, but the best insurance is prevention.

For more information on the opioid epidemic and what you can do to protect your business, check out the RMNL Opioid Edition online.

Smarter, Faster, Healthier: More Mobile Apps for Pharmacies

Wednesday, June 12 2013 Submitted by Pharmacists Mutual

Last month, we brought you some of the best iPad apps for pharmacists. We also received a lot of great response about some of your favorite apps in the comments section.

This time, we’re focusing on the technology solutions from our partners at RXinsider.

RXinsider and has been a friend to pharmacists – and health care in general – for nearly 15 years. Their mission is “to develop unique, practical, and successful technologies that support healthcare practitioners throughout their continuum of practice.”

RXinsider’s solutions range from B2B, career focused, educational and more. They provide a wide range of interactive solutions, including a massive virtual pharmacy trade show, search engines and email marketing. RXinsider has also developed a number of mobile apps to help make pharmacists lives easier.

Here are just a few of RXinsider’s web-based mobile apps for pharmacies:


Pharmacy Platinum PagesPharmacy Platinum Pages
Check out the “Yellow Pages of Pharmacy.” Serves as a comprehensive buyer’s guide with more than 220 profiles. Browse through products & service providers in everything from insurance (where you’ll find Pharmacists Mutual!) to automation/robotics to cosmeceuticals.


Read content from RXinsider’s 20Ways publication direct through your iPhone or smartphone. Filled with tips for improving patient care and your pharmacy’s financial bottom line.


Preceptor Development AppPreceptor Development
Find a list of continuing education (CPE) programs tailored to developing preceptor skills. Search for programs by discipline, format or provider.


Pharmacy Education for Long Term Care AppProfessional Development for Long-Term Care
An all-in-one app for advancing your pharmacy skills. Combines the ASCP Continuing Education App, the Preceptor Development App, and the 20Ways Publication App.


Do you have a favorite app from RXinsider? Or do you have any other mobile apps to add to the list? Share your thoughts in the comments below!

Error Reporting: Using One Mistake to Avoid Another

Wednesday, May 29 2013 Submitted by Pharmacists Mutual

A larger quantity bottle of clonidine recently became available. This was a common medication sold at Tom’s Pharmacy, so the larger quantity bottle was ordered. When the larger bottle arrived it did not properly fit on the shelf, so the bottle was placed on its side. Sitting on the shelf next to clonidine was clonazepam.

A prescription came in for clonazepam. In a hurry, the pharmacist grabbed what he thought to be clonazepam and filled the prescription immediately, knowing the patient was waiting.

Later, the patient called the pharmacy and said his pills “look different.” The pills were identified and the patient was instructed to return the medication to the pharmacy. An incident report was written up and placed in the pharmacy’s system. In the next couple weeks, 4 more prescriptions for clonazepam were received, filled by other pharmacy staff, and dispensed to patients. The pharmacy received calls from several patients stating their medication looks different. Incident reports for these occurrences were documented in the pharmacy system.

Finally, one of the pharmacists noticed that when they went to grab clonazepam, clonidine had rolled over into the wrong space on the shelf. It was discovered that the label for clonidine was hard to see because the bottle was on its side. The solution was easy – the shelf was moved so the larger bottle of clonidine could properly stand up.

The Pharmacists Mutual Claims Study reports that the largest category of claims against pharmacists has been “Wrong Drug.” Each year this one type of “Wrong Drug” mistake accounts for approximately 50% of all claims received by Pharmacists Mutual.

“Wrong Drug” is potentially the most dangerous error.

Many pharmacies have an incident reporting system, but very few have a quality reporting system. The difference is this:

  • Incident reports are for the insurance company to handle claims, real and potential.
  • Quality reporting, or peer review reports, are for reducing medication errors and to reduce future errors.

Most pharmacies do not systematically collect information on mistakes for the purpose of gathering from errors to improve quality. Pharmacists should not rely on reporting alone. The value of error reporting systems or incident reports are found in their ability to implement new processes. Patient safety can only improve by transforming the reported errors reported into action.

In the case with clonidine and clonazepam, the first error was not properly investigated. Each time there is a mistake – even if it does not reach the patient – you must ask “How did the error occur” and “How can we make sure this does not happen again?”

Robert M. Wachter observed: “Error reporting systems can be powerful tools when the reports are used to improve the system and educate, and they are particularly valuable when those who submit reports subsequently learn that their submissions made a difference.”

Recording of errors, however, is not enough. A quality peer review system must learn from all mistakes, or “quality related events.” We can particularly learn from our success stories – mistakes that did not reach the patient because the pharmacy’s system caught them.

No one wants to make errors. However, human beings make mistakes, and in pharmacy, some mistakes injury patients. We need to continuously improve quality and reduce medication errors. One way we accomplish this is collecting and using information. As philosopher George Santanyana wrote, “Those who cannot remember the past are condemned to repeat it.”