Friday, August 2, 2013

Sometimes Life Just Isn't Fair...

As a pharmacist I've seen my fair share of patients come and go and pass on.  I'm usually not affected to hear when a customer's relative tells me that they have died.  I usually just feel surprised because one minute your filling their scripts and counting their pills and then they never get counted again.  But I've never felt sadness.  However, one of my patients, Mrs, Happysmile, recently gave me the bad news that she was just told not too long ago.  Apparently, the breast cancer that she beat and survived from more than 10 years ago has reared its disgusting face again and she was found to have metastasis.  This stupid piece of cancer not only metastasized but set up shop in her bladder, spine, and many other places.  When she told me this I felt complete and utter sadness.  My heart sank and felt like I was losing one of my family members.

Mrs. Happysmile is the kindest, most generous, humorous, beautiful customer I have ever dealt with in all my years in pharmacy.  She's followed me from the big chain monster to this small independent and has been loyal to me since my career began.  She's one of the few that would actually remember my birthday when it came up and gave me gifts when Christmas time came around and when I got married.  I don't know how much she knows about what's going on, but in looking at her ultrasound reports and lab tests, it seems like there's not much time left for her.  Mrs. Happysmile, you are in my daily prayers.  I pray you continue to live happy and smile many more days.  You deserve only the best.

Monday, July 1, 2013

Get Your Government Hands Off My Drugs...

This blog is about an article I just read.  Here is the link:

Pharmacies unwilling to take loss on insulin for Medicare patients

Poor Mr. Carr.  He can't get his insulin filled because his insurance is paying the pharmacy less than what it actually costs.  In basic terms, it's like a store buying a shirt from the designer for $50, then selling it to a customer for $10.  It doesn't make business sense to practice that way.  And it's all because the government has it's greedy and stupid little hands on his healthcare.  Don't get me wrong, I am a big supporter for those who are disabled and low income to receive some sort of help for their insurance and healthcare costs, but at least do it the right way. 

According to the article, "Medicare has not raised its payment for insulin under Part B since 2003."  2003!! So they think that in 10 years, the price is going to be the same?  Excuse me, has anyone in Congress gone to a gas station recently, or even a McDonalds or supermarket?  That gas, or Big Mac, or box of cereal cost the same as they did 10 years ago?  That house that you live in costs the same today as it did when you originally signed the ownership papers?  

It's not just the government sponsored programs that have this issue.  The big insurers also do this as well. When I call Caremark to ask them why they are paying me $15 under my cost, they tell me that the pricing schedules and updates run once a month.  I'm sorry, is my pharmacy open only once a month?  No, I open every day and you should update your freaking pricing files everyday so I can make a profit as well, not only you.

"A Medicare spokeswoman said the price is set in federal law — at 95 percent of the average, wholesale price in effect on Oct. 1, 2003. So it requires Congress to change it,".  Great, so this means it will take another 20 years to resolve the issue, in the meantime, Mr. Carr can go into diabetic ketoacidosis and be hospitalized another 50 times and waste more tax money being treated in a hospital.

Maybe the government should open up a pharmacy and provide him with his insulin.  Let them pay $100 dollars to buy it from the manufacturer and then let them get reimbursed $75.  Then we will see how fast they change their policies.

Tuesday, June 18, 2013

Buy Something!!

Yes I know it is difficult to compete with the big chain companies.  Yes I know that they have a store relatively close by.  Yes I know I am taking a risk.

Why is it that people feel the need to come in to the store to say those things to me.  Would you like to know how I can survive and keep helping the community and providing people with better service and improve overall health?  Instead of walking in the store to just ask me what I was thinking opening a pharmacy, maybe you should actually buy something.  Maybe you should transfer your prescriptions to my pharmacy.  I've had to hold my tongue so much because I just want to cuss out those people that don't understand why I would open a business.  Thanks for coming in the critique the place and my decision and buy nothing and leave.  You are a real asset to me.

When I worked at a chain, I was amazed by how much people complain about every little thing.  I once had a customer that had a problem with our service every single time he came in, and for some reason, he came month after month after month to fill his scripts.  I'm not sure the way his brain works, but in my brain, if I get bad service every month and every visit for 3 years, I'm probably going to start looking for a new pharmacy to start getting my prescriptions.

I'm a little biased towards small businesses.  My father owns his own business and was able to put me and my 2 sisters through college with that business.  So even before I started my business, I was always a supporter of the little guy whenever I got the chance.  I have a ton of respect for all those that risked a big chunk of their money to open a store front and not know what the future will hold.

Friday, June 7, 2013

To Compound or Not To Compound...

To compound or not to compound, that is the question.  I've been going over in my head what I can do to attract more customers to my pharmacy.  I keep thinking that I need some kind of hook.  I've tried the whole excellent customer service and family pharmacy angle but the neighborhood I'm in doesn't believe it's worth the extra $5-10 dollars on their copays for using a "non-preferred" pharmacy.  And I don't blame them, a penny here a penny there starts to add up, especially when you take about 6 medications a month.

So I've been contemplating getting into non-sterile compounding.  It seems like a sound idea.  For those that may not know what a compound medication is, it is basically a medication that is specially formulated for the individual which pharmacists create at the store.  It was best described to me by one of my customers, "gourmet pharmacy."  The other thing I thought of getting into was durable medical equipment (DME) like canes, walkers, wheelchairs, etc.  The problem I see with this is that dealing with medicaid is like dealing with an older idiot brother who still thinks he's in high school and takes advantage of you ALL the time.  With the amount of audits and hoops to jump through just to give someone a box of test strips or give a cane, it's just not worth my time and patience.  So I figure I can start compounding.  With no real set prices on custom drugs, the profit potential seems limitless.  And with the majority of insurances not covering them means better margins and less audits.

Hopefully, I'll get some of these people in the door with this because daddy's gotta eat!

Tuesday, May 21, 2013

Screw You Pfizer...

This might be a little late but many of you may or may not know that Viagra will now be sold online in a direct to consumer way.  This is absolutely ridiculous.

First off, they are taking money out of my pocket because according to them they can give it to you cheaper.  How about not making a 30 count bottle cost close to $800 and people won't complain that it's too expensive.  Also, I'm hoping they have licensed pharmacists at the company that will be taking care of the patient counseling, medical history check, etc.  The reason they are doing this is to not help the patient out, but to increase their margin.  I'm sure that those pills can't cost the company more than $2 to make but they still make it incredibly expensive for the consumer.  They have seen a drop in sales because of this, so they decided to cut out the middle man, a basic screw you to pharmacies worldwide.  And the whole story of them not wanting people to buy fake Viagra online is crap.

Why don't they cut out the doctors too and set up a skype session with a Pfizer doctor.  Who needs medical professionals anyway, their years of sacrifice and schooling to learn how to treat potentially dangerous diseases and how dangerous drugs work is all for show.  We all just did that for fun because we were bored, kinda like reading Hunger Games on our free time.

What's scary is that if this is successful and the corporate monsters see their margins rise and their profits soar, what's to stop them from doing the same thing with all their drugs.  What is Pfizer decided to start selling Celebrex on their website, then Lyrica, then Enbrel.  Then when all those go well, the Lilly company will come out and start selling Cialis online.  And the vicious cycle goes on.

I really hope those organizations that are designed to help out pharmacists, specifically retail pharmacists, and the organizations for independent pharmacists are doing something to try to stop this.  This could be the small snowball that eventually leads to an avalanche of problems for all pharmers.

Friday, May 17, 2013

Crackhead Twitter, Oxy Facebook?

There must be some kind of social networking website or iPhone app that all junkies have that they use to communicate to one another.  I swear, they must make a post or something and their alert goes off.

Usually when a person who has a legitimate prescription but they just reek of a junkie, I tell them we don't have those oxycodones in stock.  But once in awhile I like to mix things up and make the junkies feel like it's the luckiest day of their lives and fill them.  The look on their faces when I say yes and that it will be ready in 15 minutes is like watching a kid wake up Christmas morning and seeing that Santa finally came.

And every single time I fill one for them, I get a plethora of others with the same prescription for the next 5-6 days or so.  It's like making a tiny crack in a damn wall, you make one little crack and then the damn bursts and you got meth heads, crack heads, and pill poppers flooding the store.

In a way, they are some of my favorite customers.  First off, they always have a story to tell, either of how they have been to 100 pharmacies or how their roommate stole their last bottle and that is why he his early this month.  And second, I make so much money off of them.  These people will pay anything as long as they get it.  People in chains may not realize this, but that 120 count oxycodone they are dispensing costs the pharmacy about $25-$30, and the AWP is about $175ish, that's a huge profit.

So if there is a Twitter for junkies, I want in.  I would love to read their posts.

Wednesday, May 8, 2013

Urban Outfitters Under Fire For No Good Reason...

So I recently came across this article and news story:

Urban Outfitters Under Fire

This article is about a retail store that is currently selling Rx themed merchandise.  For example they sell a flask with a prescription label that says "Boozemin, Drink as much as you stomach can handle."  They also sell beer can coolers with the outside making it look like a prescription bottle.

And the kicker of the story is that there is a group out there making it their sole purpose to make sure things like this aren't sold.  According to them, they feel these products are promoting drug abuse of prescription medications.  The feel that the tweens that are seeing these things will be compelled to experiment with their parent's medication at home.

Holy moly, are these people serious?  It amazes me how nowadays it is so easy for people to point the finger at someone else and not look in the mirror.  So instead of talking to the parents to make sure they are more careful with their prescriptions are having these parents talk to their own children that the stuff in the amber vials isn't candy.  The group is probably the same ones that believe it's the video game companies fault that someone goes and shoots someone.  And as for the crackhead in the video that didn't like the stuff because it might trigger is addiction again, screw you, it's not my fault you ruined your life at one point and i'm not going to hide potential "triggers" from your view.

Personally, as someone who needs a drink or two after a shift in the pharmacy think these products are hilarious and amazing.  So for all those in that group and people who are on their side, take that collective stick out of your asses and be responsible for your own shit.  Stop blaming other people for problems that can and should be resolved at home by yourself.

BTW, I just bought some beer holders.  Peace.

Tuesday, April 30, 2013

Beauty of Blogs...

I never thought of myself as a writer and a person to express my opinions, but the internet does very strange things.  I consider myself as more of a conservative person who tends to not make his voice none unless the situation calls for it.  When I got out of college, I was all wide eyed and gun-ho about working for a big chain.  The thought in my head was that I can start off as a staff then move up in the ranks and maybe even one day being a DM or something.  Then year after year of working my tail off and engaging with my customers and helping out my local community, I realized it didn't matter how hard you worked and loved you were by the community and those you served.  It was all about the numbers and the area you work in.  It's all about those 2 or 3 people who don't understand how a pharmacy works and are upset by your service who always seem to call and get a survey receipt.  Oh, and they are usually all on anti-depressants and anti-psychotics.

I love reading the blogs because for a time, I thought I was the only one out there who felt the way I did.  The only therapy I had was to call the PIC of the closest store and gripe with him.  I thought that maybe it was just the area I worked in.  Then I discovered the internet blogs and saw it was a worldwide problem, from California to Montana to the United Kingdom.

My goal is to have an outlet to spew my thoughts and to maybe show a fellow pharmacists that they are not alone.  And once in awhile show the random customer that stumbles into my website and show that we do a lot more than just count pills and put them in bottles.  And I also want to give a shoutout to all those other bloggers that do what they do and provide me some much needed laughter and inspiration to get me through my day.  Check them out on my reading list to the right.

Thursday, April 25, 2013

Narcotics Like Candy...

I've had the opportunity to work in both a low income urban area and an affluent suburban area.  My first job as a pharmacist was in the urban area.  There, most of the population consisted of low income families on medicaid, old people on medicare, and a predominantly Spanish speaking population from Central America, South America, and the Caribbean.  There, I thought I dispensed a lot of narcotics, and controlled meds, but when I moved and got transferred to a mainly white suburban area, I was completely dumbfounded.

The amount of narcotics I dispensed in that pharmacy was ridiculous.  We had to have 3 safes there just to be able to lock up all that we had in stock.  I figured maybe the amphetamines would be the big seller since doctors nowadays love to throw around the diagnosis of ADHD to anyone that comes through the door.  But the percocets, oxycontins, and roxicodones were being passed out like candy.  People would come in with prescriptions for "chronic intractable pain" and getting quantities of 180 or more.  Seems like everyone and their mother had "chronic intractable pain."  And what was sad was to see young adults and college students come in with those scripts.

My feeling is that the doctors in the urban area seem to have a grip on their practice and are professional about their work and don't give in to what patients say.  They are firm in their belief that they know more than the patient and even though a patient says that they want an antibiotic, these doctors will say no because you are not suffering from any sort of bacterial infection.  In the suburbs, it seems like the patient has more control than the ones that went to medical school and devoted their life to medicine.  They think that just because they did a quick google search, they know what's best for them.  And unfortunately these doctors give in to them because they are quick to post on facebook, twitter, blogs, etc. on how dumb this doctor is because he or she said that they don't need to take XY drug.  And just because you are getting bad grades in school because you can't focus on your work because there is a frat party you'd rather go to or a round of Halo you want to play doesn't mean you need Adderall, it means you need to straighten out your priorities.  I'm all for being responsible for your own healthcare, but let decisions be made by the professionals.

Wednesday, April 17, 2013

I Love My Job...

I recently went through and read my blog and I've come to see that it may seem as I hate my job.  I'm sure there are people out there reading saying "Why don't you just get a new career?"  Well, it's because I love my job.  I couldn't imagine myself anything other than a pharmacist (maybe other than a professional baseball player).

I remember as a young one, going with my mother to the local pharmacy and feeling like it was a store that had all that I ever wanted.  There was cool pens, little keychains, trapper keepers, small gifts, and best of all, loads of candy.  It wasn't until later that I learned what the pharmacy was actually there for.  And I was fascinated by the concept of taking a pill and it working throughout the body and actually find the purpose it was intended for.  When I was in high school, I finally got my first job as a pharmacy tech.  I worked in an independent store and my experience there validated my desire to become a pharmacist.  I worked as I saw people come in day after day and get their medications, all the while answering the countless questions people asked.  Back in those days, the profession of pharmacy was ranked #1 as the most trusted professional year after year.

Now, as a pharmacist, I live for helping people.  I enjoy filling scripts and making sure everything is in line.  I also enjoy the consultations most of all.  I'm honored that people come and ask me questions and consider me an expert in what I do.  In my mind I always think of the saying that if you love what you do, then you will never work a day in your life.  I feel that as a pharmacist, I haven't worked a day yet.

Tuesday, April 9, 2013

Sick Days....

It's days like today where I wish I didn't work in the healthcare field.  I am here at work, sick as a dog, and can't leave.  It's not because I am the owner and sole pharmacist of my store, it's because I'm a pharmacist.  I did my fair share of rounds at a chain.  I was pharmacist in charge at a high volume store in an urban area at one point of my career.  But it's the same there too.  Let me paint a picture...

The night before I work, I start feeling achy, feverish, stuffy, coughing, sneezing, runny, pretty much everything imaginable.  I call my district manager/supervisor and let them know what I'm feeling and tell them that I'm not sure if I can work tomorrow.  Then he/she tells me that they are going to call around and see if they can find me coverage, but, if they don't call me back to let me know, then assume that no coverage was found and go into work anyway.  So I go to bed with no call back and sleep for about 2 hours because of my sickness.  I get into work and call my supervisor again and say that I'm dying out there that I can't work these 14 hours I'm scheduled to work.  He/she tells me that they will make some phone calls and maybe I can get out of work early.  A little hope sparks me.  I work and work and work, checking prescriptions, sneezing in pill bottles, and giving flu shots.  Minutes turn to hours and next thing you know, I've been working for 13 and 1/2 hours already.  I close the pharmacy and about 10:30 and drive my 35 minute commute.  After getting home and showering, I get to bed close to midnight.  Time to go to sleep and do this all again tomorrow.

Unfortunately, that's reality for pharmacists.  I'm sick now, but like I said earlier, I run my own store, so being sick is not so much of a big deal now.  I suck it up and fill my scripts, as many as I can.  And there's the benefit of not working 14 hours.

Feel free to leave a comment...

Friday, April 5, 2013

Mandatory Mail Order...

This post is in response to something I found on the NCPA website.  Here is the link...

Mail Order Waste

Basically, it's a series of photos that pharmacists and patients took of their medications that were sent through mail order.  For whatever reason, be it the unfortunate death of a loved one or just simply the doctor saying that the medication was no longer needed, people received a 3 month supply of the drug in order to "save" money.  Therefore, many boxes and of unused medication pretty much goes in the trash.

For those of you not in the pharmacy profession, you are probably saying they should just send it back and get a refund or part of their money back.  However, the rule usually is, once a medication leaves the pharmacy and is paid for, if you return it for whatever reason, we are NOT allowed to resell that drug.  So if you bring it back to us, it's going in our trash.

These mandatory mail order programs and specialty drug mailings are marketed as a way to save the patient some money.  What it actually is doing is making more profit for the insurance companies.  They tell pharmacists like myself, who owns his own business, that we can't fill your medication, even if you prefer the hassle of walking or driving to your local pharmacy.  And for specialty medications, which normally are crazy expensive, can't be filled in my store, so I lose a potential $5000 check in my bank account.

I believe people should have a choice.  If your choice is to get your drugs through mail, then I'm not going to complain, just like I don't complain if you choose to go to Walmart to fill you scripts.  But the fact that it's mandatory and because it's insurance from your job, you don't really have a choice to switch insurances either.  I've talked to way too many former business owners that had to close their doors because of this.  It's a shame.  This is America, give the patient the freedom of choice!

Monday, April 1, 2013

No More Shortage...

I've been asked by many people, either on the internet, customers, or prospective students if there still is a demand for pharmacists.  When I was applying to schools, I remember people sending me articles of how different pharmacists were receiving ridiculous signing bonuses or even given cars to sign on with the big chains for 1 or 2 years.  Then when it was time for my graduation and my job hunt began, I was offered just 1 signing bonus from a chain to work for them for 1 year.  Now I talk to interns working as techs who are reaching their time and they the time of incentives is pretty much over.  It seems as if that shortage of pharmacists is over.

Personally speaking, I left my job at one chain because of the way I was being treated by the management.  I don't know if it was my district or company wide, but I got fed up of being treated as a robot who eats, sleeps, and talks company propaganda bull.  It took my about 10 months to actually find a full time job as a staff pharmacist.  I was able to make a living by working about 25 to 35 hours a week as a floater for independent pharmacies.

This seems due to the overwhelming increase in the number of pharmacy schools opening.  Every time I look around, there is a college or university now offering pharmacy as one of their majors.  When applying to colleges, everyone applied to a number of schools and always applied to one that was a guaranteed acceptance because they accepted everyone who applied.  These safe schools, or joke schools, are opening up their own pharmacy programs.  We need to treat pharmacy just like medical school is treated; it needs to be difficult to get into.  These graduates are responsible for people's lives.

I also see a trend in the chains that even though we are filling more prescriptions than ever and they are opening up new stores all the time, they somehow are more concerned with cutting hours and taking away overlap to make more profit when pharmacists are dying out there on the bench.  It seems like the highest number of jobs would be as teachers.  And it looks like the only thing that might be good about Obamacare will be the possible increase in pharmacy jobs due to everyone getting healthcare.

Saturday, March 30, 2013

Forget Pharmacy...

I think I've made the wrong decision on a career.  Don't get me wrong, I love what I do, but to be able to be paid for playing a game and get paid a lot more sounds awesome.

Recently, 2 major league baseball players were given contract extensions of massive proportions.  Here are the links to the stories:

Justin Verlander - $180 million
Buster Posey - $167 million

I've officially decided to have a male child and start training him early.  I myself will study how to make good investments and make sure my son will not make stupid decisions with his money.  And once he makes it, bye bye pharmacy.  I'll even give him a cool first name nickname like Chipper or Slim or Pokey (and yes, baseball players tend to have weird nicknames, point in case Oil Can Boyd).

But all kidding aside, congratulations to these ball players.  I definitely respect what you do and know that it takes years and years of sacrifice to achieve the skill to become a profession.  I tip my hat to you.

Thursday, March 28, 2013

Smooth Operator...

I feel things can go much more smoothly in a pharmacy if the pharmacist can make a substitution without having to consult the doctors.  There have been talk of this before, but nothing has really gotten going.

What I'm referring to is when a patient brings in a prescription for Nasonex and their crappy insurance either doesn't cover it or requires a prior authorization.  In normal cases, a pharmacist would have to tell the patient  that they are sorry but their insurance isn't going to pay for the medication.  Then the patient gets angry and complains that they pay $9999 a month for this insurance and that it is impossible that they don't cover it.  Then we tell them that we have to call the doctor to get it changed.  We then call the office and get a nurse/receptionist that when I say "I'm calling from Blah Blah Pharmacy", I immediately get cut off and told "For refill requests you have to fax it, we don't give it over the phone".  Then I have to explain to this person that I'm not calling for a refill, I'm calling because a med is not covered.  I give them the information and the nurse repeats back to me "Ok, Lasix isn't covered", which I then have to correct them and spell it out.  Then I get told that the doctor is busy and that I will get a call back in either 10 minutes of 1 week (I exaggerate a little).  Then I have to turn to the patient and tell them we have to wait for the doctor to call back and that they have to leave and come back later.  Then I get cursed at when in actuality, this entire problem could have been avoided if the doctor used his or her brain and just prescribe something pretty much guaranteed to be paid for.

So I'm for the pharmacist being able to use their knowledge and make a substitution to fluticasone (Flonase).  See how quick and convenient that was for the patient, pharmacist, and doctor?  There is one doctor in the area where I work that I must give kudos to for his prescription writing.  When he writes for a brand that he knows there is an equivalent that has a generic he writes on the script "if not covered, may sub to any covered generic in same class".  So for example, he will write a script for Nexium and will put "may sub with generic PPI".  So, I'm able to switch to omeprazole or lansoprazole if need be.  What an outstanding idea!

Your thoughts?  Comment below...

Tuesday, March 26, 2013

Should Pharmacists Bill Insurances for Services?

Should pharmacists be able to bill insurances for services they perform?  I think that they should.  Pharmacists aren't just pill pushers who are like robots where all they do is count to 30 and stick a label on the bottle.  We are more than that.  The schooling we go through is pretty intense.  We don't just learn about the drugs and how it affects the body, they make us learn about the disease it treats and how to disease manifests.  We learn the tests that need to be done to diagnose them.  We also learn how to treat certain things both pharmacologically and non-pharmacologically.

Yes, I understand we don't learn how to do certain procedures, like drain an abscess and suture a wound, but for many common things, we are just as knowledgeable as the common doctor.  When I've gone to my primary doctor and I look at the breakdown of the bill, I see that I get charged for pretty much everything.  Some doctors just bill an overall "physical" for a flat fee, but others itemize it and break down the individual procedures.  Blood pressure check, $X.  Temperature check, $X, etc.  People often bypass going to the doctor's and come to the pharmacist to see if he or she can recommend something to them.

In my school, we were taught how to do these basic things, blood pressure, blood sugar, mini mental status exam, reflexes, diabetic neuropathy, etc.  Pharmacies don't offer these services because we don't get reimbursed for them.  As an independent pharmacist, I would be willing to offer these services in order to get people in my door an away from the chains.  They take enough business as it is with them being "preferred" pharmacies, offering $4 90 day supplies, and mandatory mail order.  Vaccinations is a great first step for people to realize that pharmacists are more than just a person with a spatula and an empty bottle.

Friday, March 22, 2013

Zombie Pharmacists

Those of you not in the industry may not know the hours of a typical pharmacist.  For those of you in it, I feel for you.  Pharmacists sometime are walking, talking, counting, typing zombies.

Well, the average chain pharmacy is open from 8 in the morning until 10 at night.  That's a full 14 hours.  I say full because the majority of pharmacists don't have the luxury of taking a couple of 15 minute breaks and a 30 minute lunch because it is just too busy.   And god forbid we do decide to tell a customer that it will be ready in 30 minutes because the pharmacist is taking his or her lunch.  We all know too well that that will be the customer to call the 800 number and complain to the higher ups and then we get written up.

I used to work in a pharmacy in an urban area because I grew up not too far from there.  When I became a pharmacist and finally had some money, I moved to the suburbs to get away from the city life.  So my commute is about 30 minutes if there is no traffic.  However, I happen to work at a pharmacy that is close to the Lincoln Tunnel, Holland Tunnel, and George Washington Bridge, so my commute is more like 45 minutes to an hour depending on the day.  So my day actually starts at about 6:30 and usually ends at around 11:30. I remember one week, my partner had first had to attend a funeral and wake and then at the same time had gotten really sick, so since there was no one the district manager had to replace, I had to bite the bullet and work 6 days in a row.  So that was five 14 hour shifts and one 8 hour shift.  If you were one of my customers that week and I growled at you or dropped an f-bomb or two, my bad.

I myself used to work these hours at a store that did about 600 scripts a day.  I, like most pharmacists, have made mistakes.  It's tough juggling both being as accurate as possible with each and every prescriptions and churning out the 600 plus scripts I need to fill in what the corporation deems a "timely manner."  Not going to lie, but our definitions of a timely manner differ quite a bit.

I used to be the type of person that had a zest for working in a busy store.  Then I came to an important realization that Joe Schmo working at the pharmacy in Nowhere, USA fills about fills about 100 scripts per week and get paid just about the same as I do.  Also, when the annual review comes around, he gets a raise for being about to satisfy his 100 total customers, whereas I didn't receive a raise because my drive thru time was 5.6 seconds instead of 5.0.  So I got fed up and decided to go to greener pastures.

I know there are studies out there that show a correlation between how many hours in a shift and mistakes.  Why do most big chains ignore these studies?  Why is the public not demanding those that make pharmacists work 14 hours change their policy?  If their in existence to help their patients manage their medicine and improve overall health, then shouldn't their goal be to minimize errors?  But, unfortunately, they are in existence to please their stockholders and increase their overall wallets.  So the world of pharmacist zombies will continue.

Wednesday, March 20, 2013

Things I hate hearing

Here are some things I have hearing as a pharmacist, so if you're my customer and you say any one of these, don't be surprised when I jump over the counter and pump your belly full of potassium pills (and try to stab you with my blunt spatula).

1.  My copay is $3.50?!?!  Why so much?!?!

2.  Why isn't the insurance paying for it, didn't the doctor write that I needed it?

3.  I'm allergic to that, it made my stomach hurt

4.  15 minutes?  But the medicine is made already, you just have to put a label on it

5.  Too soon? Oh i lost my pills/my roommate took them/they fell in the sink/etc.

6.  Why do you need my ID for Sudafed, Walgreens doesn't ask for it

7.  What aisle can I find the milk?

8.  How much is amoxicillin?  Ok, can I have it?  Wait, your saying you need a prescription?

9.  Why do I even have insurance?

10.  (Phone call) I have a prescription in my hand, can I tell you what it says and you have it ready?  I will be there in 5 minutes

I'm sure there are a lot more.  What makes you all heated?  Leave it in the comments

Tuesday, March 19, 2013


So this happened to me the other day. It was just a regular day and the pharmacy, people coming in, thousands of phone calls, my stomach growling, you know, the usual. Then the most unusual character comes up to the consultation area.
I call him unusual because he was dressed in shorts, tshirt, and flip flops. It’s still winter and he looks like he’s ready for the beach. He’s got a plastic bag in his one hand and reaches out his other to shake mine. I shake because I don’t want to leave him hanging and we begin our conversation.
Customer: “I was wondering if you could help me with something and ask you a question”
Me: “Sure, ask me two if you’d like”
Customer: “My girl took a pregnancy test and I was wondering if you could tell me about it”
Me: “Tell you something about it, well, what it does is read the hormone levels in her urine and lets her know if she’s pregnant”
C: “No, I know all that”
Then he reaches into the bag he was carrying and pulls out the freaking stick. He then tries to hand it to me.
C: “Does this mean she’s pregnant”
After taking a step back out of disgust, I look and tell him that yes, she is pregnant. I chose my words wisely, and didn’t say congratulations because judging by the look on his face, he definitely was not expecting this.
So he leaves and during some down time, I remembered he shook my hand and handles the test with the same one. After throwing up in my mouth a little, I quickly pump about half the hand sanitzer in my hand and proceed to clean.
Seriously?! Some people just don’t have proper brain function.

When calling in a prescription...

To all the doctors, nurses, dentists, PAs, or whoever calls in a prescription to a pharmacy:  please follow these guidelines and your relationship with your pharmacist will be much better.
First complaint I always hear from all of my fellow pharmers is that people need to slow down!  I’m not sure if you realize this, but the words that are coming out of your mouth need to be written down and all I have is a pen and paper.  Don’t start rambling without any pauses because I can’t keep up.
Spell out the name of the patient and doctor and give us the DOB.  That last name might be common place in your place of origin but I don’t always know where that silent H goes.  And you might be the only Dr. Patel in your neighborhood, but my computer says there are over 500 of you, so please specify with your first name, DEA number, or NPI.  And lastly, little old Maria Rodriguez from Main Street may be your only Maria Rodriguez that goes to your office, but I have 18 different Maria’s in my system, so give me the patient’s DOB.
Please give me quantity and directions.  You guys might be able to get away without giving insurance companies exact details on what you do, but if you prescribe Coumadin #100 with direction as “Use as directed” I’m going to tell you to please give me the EXACT directions.  Because if I get audited, that money I just made off the prescription is going to be taken right back.  Same goes for insulin, prednisone, etc.
Please don’t call the prescription in and tell the patient that the pharmacist will have it ready in 10 minutes.  You are not at my store and you don’t know my current workload.  And also don’t give a price to people when you clearly don’t know how much it cost.
It’s also frustrating how many of prescribers are not familiar with the laws of guidelines that entail prescriptions.  No you cannot phone in a CII, you can only phone in a 3 day supply and must mail the prescription immediately or you will be reported to the DEA.  No you cannot give more than a 6 month supply of any controlled medication.  And no I cannot make an exception for you, it’s my license on the line. 
I don’t think I’m asking for anything that’s not close to common sense.  But, all in all, if you are nice and personable to me, you will get the same in return and maybe I will overlook the mistakes you make and not get as frustrated.

Wonderful Customers...

First off, I would like to say that 85% of the people that come in and drop off and pick up prescriptions are fine and dandy.  I appreciate them and look forward to seeing the frequent flyers once a month (or sometimes once a week for some).  But there are about 15% of you out there that just amaze me.
I admit, there are times when I can’t understand the crap that your doctor has written on the prescription.  Most of the time, I can look at the first letter, the strength, and directions and decipher it.  But when I need more help than that, I usually ask the patient “What did you go to the doctor for?”  If you tell me I went because I have a cold, my brain works and focuses on antibiotics and cough suppressants   There are way too many times when I ask that simple question and the answer I get is “I dunno.”  Or “What did the doctor tell you?”  And they respond, “Nothing…I dunno.”  So your basically telling me that you went to the doctor just to go, he gives you a medicine that you have to ingest that affects your body and possibly changes your internal chemistry and you didn’t bother to say, “Hey Doc, what are you going to give me?” or “How will this help my _____?”  No, you come to the pharmacy to fill it and when I tell you it won’t be ready in 5 minutes because I can’t understand what’s written you complain that I don’t know how to do my job.  Ugh.
Please carry your insurance cards with you.  And no, the card you give to the dentist and the doctor is not always the same card that I need.  And for the senior citizens, your Medicare Part B card (red, white, and blue card) is not your prescription insurance.  And if your copay is $1 to $15 dollars, don’t complain.  Your one of the lucky ones.  You may not know this but there are drugs where for 1 bottle the cost is over $4,000.  So your $15 copay doesn’t look so bad. 
Your insurance doesn’t cover everything.  There will be times when a med needs a prior authorization or non-formulary.  You would probably say “But the doctor wrote it so it has to be covered.”  Well, the reason for it is because that prescription for the brand new brand name medication the doc wrote for has a cheaper cousin that does the same exact job and works equally as well for a fraction of the cost.  The only reason that doctor actually wrote for the medication is because he was probably enamored by the blonde pharm sales rep that stopped by his office and gave him some donuts.  Trust me, that is the reason why.  You may wonder, “Why do I have to use the cheaper ones?”  Well, what people don’t realize is that the more generics you use, the lower the cost of healthcare becomes.  It’s simple math, if your insurance has to pay out an average of $700 a prescription to a pharmacy, then they have to charge you a higher monthly rate than if they pay pharmacies $10 a prescription.  
There are many more stories, but my hands are cramping, so I’m sure there will be a part two.

Feel free to leave your comments!