Articles by Michael Bracher

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When it comes to a medical emergency, you do not have time to make the hard choices of which 24 hour emergency room to choose. You have most likely noticed the rise of stand alone emergency rooms. These seem to pop up everywhere, and have maybe contributed to some confusion surrounding medical care. It is important to know when, where and how to use an emergency medical facility. So, do not let these new types of emergency rooms add to your confusion. Instead, take the time to understand them, and make the right choices on using them.

Let us look at some key differences between traditional ERs and stand alone ERs:

The Hospital:

  1. There are notorious long wait times to be seen. There are a few factors that cause this to happen. The level of trauma is a big one. Medical staff will automatically prioritize patients based on level of trauma, and will see the one’s with more acute issues first. This is a medical practice, and part of the system. The other big issue is number of patients. Traditional hospitals are usually overwhelmed, and do not always  have the capacity to serve everyone quickly. This will add to wait times.
  2. Tests and results take awhile to process, and add to the overall long wait time. This is a downfall, and can add to time in the emergency room. These tests and results are normally processed outside of the emergency department, and this adds to time.
  3. The service level can seem uncoordinated and impersonal. This is often due to being passed around from professional to professional, and it can add to the feeling of simply being a number. It can also add frustration and stress as you may have to explain your situation multiple times.

The Stand Alone:

  1. This is a newer concept, and is a hybrid that is designed to treat a combination of life threatening and non life threatening illnesses. This free standing 24 hour emergency room facility is changing the way medicine is done. These facilities are well-equipped, and can treat patients efficiently and quickly.
  2. Service is coordinated and very personal in these facilities. You are assigned staff that will treat you from beginning to end. They are fully devoted to your care, and make every possible effort to get you in and out. They will take care of all testing and diagnostics, and you will not be passed around from person to person. This ensures you have a better experience, and will make the patient more at ease.
  3. The points above lead to shorter wait times, and faster service. Both of these points will ensure you are seen quickly, and are back to your life as quickly as possible. The ER is never fun, and it is great to have folks who care, and can get you in and out fast. This is the design of these new facilities.

To sum it up: have a plan in place for emergencies, and look into choosing a free standing facility. This may be the change in medical care you need.

Have you ever wondered how the pharmaceutical industry works? How do they determine if a drug is safe? How do they know the side effects? In order to understand it a little better you can look at some of the terms and definitions used.

Area Under the Curve (AUC)

The area under the curve of a plot of drug concentration in plasma against time. AUC has units of concentration * time (for example ng.h/ml). The AUC taken to infinity can be used to determine the bioavailability of a drug product.

Bioavailability (BA)

A measure of the fraction of a drug that enters the systemic blood circulation after oral administration. The usual measure is the ratio of the AUC of two different formulations of the same drug, corrected for dose. If an intravenous injection of 1 mg of a drug gives an AUC of, say, 1000 ng.h/ml, and a 5mg tablet gives an AUC of, say, 3000 ng.h/ml, then the oral bioavailability of the tablet is said to be 60% (=3000/5*1/1000*100) of the injection.

Chemistry, Manufacturing and Controls (CMC)

The section of an ANDA or NDA where all the data on synthetic chemistry, impurities, formulation, manufacturing, packaging, specifications, analytical methods and stability are submitted.


A component of a tablet or capsule, usually present to add bulk to the dosage form. The most commonly used diluents include lactose, microcrystalline cellulose and native or pregelatinised starches. Dibasic calcium phosphate and mannitol are also used.

Endotoxin A term for lipopolysaccharides deriving from the cell wall of gram negative bacteria. For excipients to be used in inhalation or injectable dosage forms it is important to control the level of endotoxin to a low level of typically not more than 5 EU per gram.

Ok, you might be feeling a little overwhelmed at this point and that is ok. There is a lot of chemistry going on and unless you are a chemist you may have to read through some of these things once or twice. Remember that the point of reading through these terms is to get an idea of what the pharmaceutical industry does. Understanding some of these terms should help you understand how drugs are evaluated and administrated. There is so much going on with just one drug. Add that to the amount of people that take that drug and you have a lot of different reactions and side effects. No wonder there seems to be such controversy in this industry. Let’s try a few more definitions.

FDA Form 483 (483) A form of observations usually produced after an FDA inspection of a drug development or drug manufacturing facility. Only significant deviations from cGMP are listed and thus 483 observations are only negative.


A measure of the resistance to abrasion and breakage of tablets during a standardised test involving tumbling tablets in a rotating drum. Details of the equipment and test protocol are found in all main pharmacopoeia. A limit of not more than 1% weight loss is generally taken to be a satisfactory measure of friability.

All of these words don’t even begin to scratch the surface of the pharmaceutical industry. You can imagine all the difficulties that can arise even with all of the controls in the place. People will always have side effects to drugs and there is no way to eliminate that.


drug tracking

I work at a small company and the owner likes to do trade shows. I on the other hand do not like it so much. He is very personable and outgoing. He can talk to everyone and could talk for weeks on end about the business, which is a good thing because you should be passionate about what you do. The first time I attended a trade show with them I was new to the company and didn’t have a whole lot knowledge about what we were promoting. I mostly stood back and watched as my boss and co-worker worked the floor and probably engaged with every single person who attended the trade show. It wasn’t my best but it was a learning experience.

The next trade show I attended went much better but I still felt a little uneasy talking to people about what we were promoting. I was involved with the planning of the trade show booth design and I was really able to contribute. We wanted to show how our LED lights could save people a lot of money on power bills while simultaneously brightening stores and offices. I had the idea to bring in some of the old style lights and the new lights to show people the difference. My co-worker then had the idea to build a structure that we could take with us and mount the lights how you would see them in a ceiling.

We ended up having the best trade show booth design there. It was bright and inviting and people would come over just to see what all of the lights were about. We did really well at that show and generated a lot of leads.

The next trade show we made even more improvements. We brought in a big fan coil unit which is found in freezers of convenience stores. On one side was the original motor and on the other side was the new motor we would use. We ran the fan all day and it brought us a lot of customers. Not only did we have interesting lights but now we had a fan. People would even come walk by just to stand in front of it to cool off. This show was a huge success and our trade show booth was the coolest at the show. Both literally and figuratively.

The final touch that we added was a spinning wheel. We had a form that people would fill out and answer a question. If they listened to our 2 minute pitch they would know the answer to the question. If they got the question correct then they got to spin the wheel and whatever they landed on they won. We had Chipotle gift cards, Starbucks gift cards, highlighters, and a tool set. This was enough to get many people to listen to our promotion. At the same time people were really having fun and enjoyed our booth. We left a lasting impression on everyone with our uniquely designed trade show booth.

trade show booth

Concession stands are an American trade mark. They are in just about every sports activity you can imagine. Football games, hockey games, basketball games, baseball games and more. Concession stands appear professional sports events to college and high school events and even to middle school events. Concession stands are at concerts, art shows, fairs, carnivals and more. I can’t think of very many events that you would not see concessions. Even at the opera! What on earth would people do without concession stands? The atmosphere and experience of events without concession stands would be entirely different without them.

The concession business has become huge and companies that supply concessions are a very important part of the whole chain. For instance, if you live in Denver, can you imagine what it takes to stock Coors Field or even a simple gas station? Where on earth do they get all of that delicious and fun concession food!? That takes the knowhow and the experience of a well-established concessions company such as American Concessions. “In the fall of 1987, American Concession Supply began as a start-up venture specializing in the wholesale distribution of food concessions supplies and equipment. “When we help our customers meet their sales and profit objectives, we’ll meet ours as well.” A belief and commitment that continues to this day. I invite you to come in and visit our show room. We have on display the largest selection of Fun Food equipment and supplies in the Rocky Mountain region. We are happy to demonstrate equipment and take the time necessary to answer all you questions. We will offer only quality equipment and supplies, supported by quality service and professional advice. It is our intention to create a customer/supplier relationship that requires a crowbar to pry apart. The staff of American and myself are anxious to be of service to you!”

Right away they establish that their goal is to help their customers meet their sales goals through concession supply. If their customers do not reach their goals then American Concessions does not reach their goals either. This is always good motivation to work hard and deliver to your customer’s needs.

One way American Concessions really benefits their customers is by doing some market research and then passing that along to the customer. Here is an example:

When running a small business, you must be cost effective in every aspect. However, the cheaper priced items aren’t necessarily cheaper in the long run.

We decided to test this theory with our very own Raquelita’s brand nacho chips, to the Sam’s Club Medallion brand. The ending results may have you rethinking your chips.

We took a 6 lb. box of the Medallion chips and a 6 lb. box of our Raquelita’s chips and filled them in equal sized nacho trays. Filling each tray equally and calculating waste, we found our Raquelita’s brand produced 15 more trays than the cheaper Medallion brand. At the end, Raquelita’s 15 extra servings profited more than $35.00 compared to the Medallion

Raquelita’s Brand                                      Sam’s Club Medallion Brand

Cost Per Case: $9.46                                 Cost Per Case: $7.92

Case Size: 6lb.                                            Case Size: 6 lbs.

Servings Per Case: 35                              Servings Per Case: 20

Cost Per Serving: $.27                              Cost Per Serving: $.39


$3.00 Per serving                                                $3.00 Per Serving

$.39 Serving Cost                                             - $.27 Serving Cost

———                                                                 ———-

$2.61 Profit per Serving                                       $2.73 Profit Per Serving

X   35 Serving Per Case                                     X    20 Serving Per Case

———                                                                   ———-

$91.35 Profit Per Case                                      $54.60 Profit Per Case


The numbers don’t lie! Raquelita’s may cost $1.54 more but they produce $36.75 more in profits!


American Concession is a great place to purchase all of your concession supply needs.

concession supply

concession stand