I’ve seem to have made a few doctors upset with my last few posts. I want to help clear up some confusion about this blog, and other items of interest. I type at over 40 wpm, so expect grammar and spelling errors (yes, i’m talking about you grammar nazis out there).
This blog is the distilled down anger of the profession of pharmacy. This is the kind of stuff that really annoys us pharmacists. This is an insiders look at the profession. No matter where you work you’ll find that we all get annoyed by this
The statements made are just generalized. Seriously, take it with a grain of salt. Its meant to be angry and postal. This isnt my day-to-day life here, just aspects that really irk me.
I am no way this angry at work, nor treat my patients like this. I do however refuse to fill narcotics early and stand my ground using a firm and polite tone. If they want to get it filled somewhere else, thats fine. Doctors (and their staff) know that when they put down “Do Not Fill Until 2/5/07” that the patient will not get a single tablet until 2/5/07. Doctors respect that, I’m not a cave-in who can be threatened for medication.
This blog is used to blow off steam, steam that a lot of us pharmacists generate by working with the public. As you can see by the comments, a lot of people agree with what I say. I think that says something.
I’m never an asshole to any doctors (when I get to speak with them). Sometimes i’ll act a bit short to get my point across, but my main concern is to get the medication covered and out to the patient in a timely manner. When I tell a doctor that drug X is covered, and he wants drug A, B, or C (and gives me no justification to even try to get a prior auth, other than ‘im the doctor, this is what i want’) it irks me. We need to listen to each other, and this blog (i hope) will help doctors understand what we deal with on a daily basis. Im sure that you wouldnt want your grandmother spending $400/month for the (not covered) latest and greatest vs having a drug thats covered thats not being pushed by some drug rep (and not even give justification for the latest and greatest)
When a doctor makes a drug or dosage mistake, do I tell the patient “Hey, your doctor screwed up, i need to call them to get it fixed”? No, of course not. I say I need to call for a dosage clarification. I never ever bash individual doctors to the patients. Never ever ever.
I am never an asshole to your office or front-end staff. They have to deal with the public just like I do, and I feel that we are in the same boat (with respect to dealing with asshole patients).
Keeping us in the loop really means a lot to us. Nothing makes us happier than to get a call from a doctor in town saying “Hey, I need help with patient X”. I will drop everything i’m doing to help that doctor out to get exactly what his/her patient needs. I’ll gladly research whats covered. Got a patient with CHF and not really sure what the 4-5 medications he/she needs to be on? Call me up! I’ll tell you. Wondering why that ACE-I isnt working in that African American patient of yours? Gimme a call! We know the answer! The ‘ego’ that you all say I have isn’t myself at all, its having a person who took 3+ years of pharmacology a phone call away, and ignoring our advice.
Pharmacy is the only profession where we aren’t paid for our time or advice. Try getting legal advice from a lawyer and you’ll get a bill. A doctor? A bill. A pharmacist, a smile and advice. Even though I may never ever see this patient, nor fill a drug (and make money) from them. Igive advice to that frantic mother at 7pm on how much tylenol to give her sick baby (whom i’ll never see) the same as I do to a patient who has been here for 20 years.
We are the most accessible healthcare providers. We answer the stupid questions so you don’t get a phone call or a page during dinner. I have no problems doing this for any doctor. It really makes my day when a doctor calls up and says “Hey, you talked to patient X about Y last night after my office was closed, thanks a ton!” This sounds sappy, but sometimes your local pharmacist just needs a quick call saying thanks for the work they do and the service they provide to our patients. Those simple words will really make an impact on us.
We are the translators of big words, and make scary sounding procedures sound not as scary. We are your translators from medical to common. We are also the translators of your handwritten notes to the patient (which they cant read).
We are your eyes and ears outside the office when patients go doctor shopping, or swipe one of your Rx pads. We let you know whats going on so you can take care of your ‘problem’ patient on your turf, not the DEA.
I treat all patients with dignity and respect. I am never initially hostile to any patient regardless of sex, creed, religion, blah blah blah. However when the 5th phone call from the same patient in a day comes asking for an early fill on vicodin, I lose my temper. I don’t lose it at them, but on this blog. I never lose my temper in front of patients, nor scream at them from across the store. I write about the 1 patient that ruins my day and not the 300 that made my day. This isn’t a day-to-day blog about a pharmacist working, its about the frustrations that come with the one asshole that walks through my front doors.
When a medication isn’t covered, and we ask you (the doctor) to change it to a covered medication, give us a reason why the covered wont work. We will be happy to fill out the initial Prior Auth paperwork for you just to sign. Saying “well this is what I want” isn’t respectful to someone who is trying to help you out.
If a new drug comes out, and you (the doctor) have a question about coverage, usability, or just want to know if its just more of the same, call us! We probably read about it in Drug Topics while taking a shit, and we’ll be really upfront with you if we think its just another money-maker for a dying pharmaceutical company. We don’t get paid by the manufacturers, so why would we lie and say the latest = the better unless we really do mean it.
All pharmacists have a sense of humor. Sometimes twisted (like myself), but we like a good joke, or a tounge-in-cheek comment when you call in that Viagra Rx.
My opinions about things are just that, opinions. “Opinions are like assholes, everyone has one and they all stink”. They don’t reflect upon the profession, other pharmacists (even though they may agree to some degree) or even other doctors.
I don’t belittle doctors, think they are all idiots, or slaves of drug-reps. Although I must admit the nicest (and most willing to work with you) doctors I have experienced are pediatricians, podiatrists, psychiatrists, and medical residents. Male OB/Gyn’s can be a kick and I’ve never talked to a proctologist.
This list could go on and on and on. However:
Listening to a peon drug-rep vs your local pharmacist is really upsetting, seriously. Its like thinking the only way to make salsa is via some new rocket chef gizmo on paid-sponsoring television
Treating us like bean-counters is also upsetting. There is a reason why we went to college and have degrees (sometimes even doctorates). Sometimes we feel like we are your pharmacology book sitting there on your shelf (collecting dust) holding something up.
We are as much “wanna be doctors” as you are “wanna be pharmacists”. Anyone can work on a car, but a mechanic is going to get the job done right the first time.
So if I offended any doctors out there reading, my apologies. This blog is like going out for beers after work with your colleagues and bitching about what happened. I had a really angry response to a nasty comment (from a doctor) I received, but I think i’ll just sit on it for now.
Now approve my damn refill requests! Its been a week!