Real Life Retail 101

Pharmacy schools are notorious for filling their students heads with tales of wonderfulness and gummi-bears when they work in a retail setting.  This is due to a few factors:

  • Pharmacy school professors have not worked in retail for 10+ years.
  • Pharmacy school professors could not cut it as retail pharmacists, hence why they teach.
  • If pharmacy school told it as it is, nobody would become pharmacists.

Thats where I come in.  I want all the students to print out this entry and hang it on the bulletin board of their school, because this is ‘Real Life Retail 101′.

First some common smoke that is blown up the ass of students:

Pharmacy School: You will have a working relationship with the doctors of your patients so you can both provide the best possible care.
Real Life: The only interaction you will have with a doctor (in the rare event) is when he calls up and whines like a little bitch about how his precious medication that he prescribed isn’t covered.  He’ll bitch and moan about how he wants Altace over any of the generic ACE-I out there (or the new Soma 250 vs Generic Soma 350) and just ramble off whatever the big titted drug rep told him.  He will blame you for the insurance not covering it as if you had something to do with it.  If and when you catch an error, he/she wont even thank you.

Pharmacy School: You will be treated as an equal by a Doctor and any NP/PA
Real Life: “Just fill the damn vicodin script early, I dont have time to tell you whats going on”

Pharmacy School: You will make a difference in your patients life.
Real Life: There is some truth to that statement, for your regular patients you will have a small (if not a large) impact on their lives.  Be it getting something changed to a less-costly generic, or just dealing with the bullshit of MediCare-D.  The rest of the time you will just be the vicodin police and pissing off the crackheads who doctor shop.

Pharmacy School: You will use your deep pharmacology knowledge to the best of patient health.
Real Life: If you replace ‘pharmacology’ with ‘whats on formulary this month’  then yes, this statement is true.  You will use your pharmacy school knowledge to some extent, but to actually use it as pharmacy school’s preach it is just a fart in the wind.

That being said, here are some survival tips when working in retail:

  • Have a sense of humor – If you dont laugh at your patients or at least poke a little fun when they are not there, you will crack and go insane.  Thats why this site exists.  Make sure they aren’t standing in the store when you poke fun at how bad they stink though. :)
  • Know your patients – Say ‘hello’ to them as they walk in the front door.  Know their names, be involved in their lives if they decide to tell you about their kids.  Remember that their kids will be your patients too.  You have techs and clerks for a reason, to do the grunt work while you build a reputation with your patients.  You’d be surprised as to how much people trust what you say over the doctor.
  • Choose your battles – You’ll burnout really quick if you decide to battle every little shit that gets flung at you.  Its easier to just ignore the fact that the old nurse out there is spouting out drug information thats completely wrong than to try to tell her how the Renin-Angiotensin System works.
  • Speak English, not medicine – When you get out of school, you’ll have all these big words that make you sound smart.  Remember that your average patient can barely wipe his/her ass and doesnt really comprehend medical stuff.  Its “blood pressure pill” vs “Beta-Blocker or ACE-I” and “Water Pill” vs “Loop Diuretic”
  • Be vague when asked what a medicine is for – For BP stuff its pretty clear cut.  But sometimes doctors give medication for off-label use.  Be careful with the anti-psychotics.  Call them “mood pills/mood stablizers” not “anti-psychotics”.  Just what you need is to have both barrels of insanity being blown at you when you infer that your patient is on anti-psychotic medication.  Even be vague with the TCA/SSRI’s.  I always say “They are used for mood, for headaches, for nerve pain, etc”.  If they don’t have any of those, they need to talk to their doctor.  You’ll only make that mistake once when a doctor gives a TCA for neuropathy or migraines and then calls you bitching as to how come you told your patient that they had depression.
  • DON’T GUESS! – If you dont know the answer, look it up.  If you have any doubts on a dosage or a medication then look it up.  Don’t guess!
  • Learn from the Doctors – Look at the pediatric Rx’s you get and get a ballpark idea on the OTC cough/cold medication as to how much to give to a patient of x age and y weight.  You will be asked questions when parents come in to buy OTC pediacare drops and how much to give.  If you give what the local pediatricians give you’ll always be okay.
  • Build a tough skin – You’ll be cursed at, sworn to, etc.  Usually it’ll be by crackheads wanting their pain pills early.  Look at the source before deciding to take something personally.
  • Be patient – If you are an impatient person, then dont go into pharmacy.  Spending 15 min explaining to some 85 year old patient as she gives you the cow-stare about her medication will be frustrating.  Especially if shes too dense to realize what “once daily” means.
  • Know when to cut bait – Think of the bottom line of the store you are working at.  If a patient is making you jump through 30 min worth of hoops for an Rx that will net you $5, then its not worth it.  Give more slack to the regular patients (or ones that have been going there for 10 years).  Remember, its costing your employer $1/min for everything you do.  Know when to pull the plug and go do something that earns the store money.  Remember, filling Rx’s puts food on the table, not patient care.  Patient care will earn you money by filling Rx’s and drawing people to your store; but at the end of the day all your talking and helping earned you zero if you did not fill one Rx for that person who just wanted free advice (and will never get something filled there again).  Yeah, it sounds unprofessional, but doctors get paid to talk, we get paid to fill Rx’s.
  • Respect your techs – They are your equal, not your bitches.  Not heeding this can make the difference between them doing their “job description” vs covering for you while you go put your skills to work.  A good tech (AKA ‘Keystone Tech’ as DrugNazi puts it) is extremely hard to find, be nice to them.
  • Respect your elders – Waltzing in with your fancy PharmD and showing up all of the BS’s with 30+ years of experience is a good way to piss people off.  Be humble towards people who have been practicing pharmacy for longer than you have been alive.  You may know more book-learned material than they do, but they know what does and doesnt fly with the patients and doctors.  You cant teach experience, remember that.
  • Be nice to the Doctors Staff – They get the shit done in the office, not the doctor.  Being nice to even the most dumbass office staff can save you from waiting 4 days for that refill request.  They can push you to the top of the request stack in a pinch, and can save your ass when you screw up.
  • Shut up and do your job – There are some time where you just need to bite your lip, and just do your job.  Letting your moral/religious beliefs (AKA refusing to dispense birth control) run your job makes you a pothole in the road of medicine.  You have a job to do, just do it.  People don’t want to hear how you feel about religion, politics, etc.  They come for you for medical help so give it to them in an unbiased way.  Obviously if you have a legitimate health concern (blood clots with
    BCP, etc) then by all means, speak up, thats your job.  Refuse to fill if you feel that the medication will cause documented immediate or long-term harm to the patient, not because of how you personally feel.

I’m sure that there are more, but this is a good starting point. :)

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30 Comments

  1. Monica says:

    You are a very wise person. Continue with the great posts :)

  2. Emilie says:

    Thank you so much for that post!
    I’m a new pharmacist (sept. ’06) and I am getting quite depressed and unhappy with my carreer choice… (just don’t want to go back to school for another x years…)
    But reading your post made me feel a little better, i’m gonna think about this when I don’t feel too great.
    Thanks again! :)

  3. Zombie Met says:

    I want to print this out and stick it to my wall, to remind myself every time I get too idealistic about pharmacy. I probably will end up at least sending a link to my mom (also a pharmacist). Thank you for this, it’s what needs to be said more often.

  4. sparkles says:

    awesome advice… im gonna save it to help me ywo years from now God willing.. thanks TAP!! ur the best

  5. Jory says:

    Ya know everyone I talk to says that if I had been born 10 years earlier I would be a shoe-in for pharmacy school (I am not, nor will I ever be a 4.0 student). Instead we are stuck with these dipshit interns, not all but most, who can’t deal with patients and do exactly what you just described. I’ll most likely be left on the outside looking in as all these people who have book-smarts but no common sense (I watched an intern explain the friggin TCA cycle to a patient today to describe something). One of the things that irks me about the field.

  6. atomeyes says:

    My business partner and i started a pharmacy student recruitment company. Our first order of business was to meet with 3rd and 4th year pharmacy students and explain the real post-grad world to them.
    Explain what retail pharmacy really means, show them photos of big box stores and grocery stores and independent pharmacies, go over the pros and cons, etc.
    We left lots of jaws agape.

  7. one_angry_tech says:

    Amen

  8. mainburner says:

    You WILL have an impact on the lives of your patients. I’m not saying that you are the reason most of your patients haven’t kicked it yet, but talk with the the daughter of one of your blue hairs and I’ll bet you hear this: “Ma doesn’t do anything until she talks to (insert your name here).”

  9. Nicole says:

    We just had to do our first patient counseling lab two weeks ago in our intro class… biggest load of crap ever. There are 15 different areas you HAVE to hit, like it is life or death… INCLUDING inviting the patient to come sit down… excuse me but when will that EVER happen in a real pharmacy?? Also, we had to “pretend” to call the doctors… our doctors were friendly and respectful, yet every doctor I have ever called when I’m at work A) has his nurse do his dirty work and she bitches the whole time or B) when they actually get off their lazy asses and call in their own script they speak 1000 miles a minute and mumble because they are probably prescribing themselves vicodin and they dont understand why you ask them to repeat themselves! I had a bad day at work today! Ha!

  10. mel says:

    This is so true. I worked in retail for almost 2 years up until this fall when I started pharm school. I pity those P1’s who don’t have any work experience who think it’s going to be such a prestigious job….at least I know better.

  11. http://openid.aol.com/rxlace28 says:

    I’m currently on rotations, and a drug rep came in to my retail location and stated that Soma 250mg was “for the stay-at-home moms that want to take their Soma but still be able to stay awake”. No shit, the Soma rep actually said THOSE WORDS. And as far as I could tell, he didn’t have big tits. (But he may have had a small *****). :)

  12. Sean says:

    I just got into pre-pharmacy at U of A. I have been a tech for 8 years and I just have to say that is the BEST and FUNNIEST website I have ever encountered. FINALLY…someone who tells it like it is. EVERYTHING that this guy says is true. ESPECIALLY regarding technicians being equals. I have worked with the RPh that sat there and only verified RXs all day and I did all the work. (He got in trouble, cause I don’t let it slide like some techs)
    So once again…RX students…treat your techs as people, not slaves. Your name may be on the door and on the RX bottles and on the diploma, but WE RUN THE PHARMACY. In most pharmacies, techs are in charge on data entry, production (counting), ringing register, INVENTORY MANAGEMENT, customer service, and don’t forget..IT IS A LOT EASIER FOR A TECH TO CALL OUT OF WORK THEN A PHARMACIST… :-)
    To Angry Pharmacist: I salute you…

  13. Brian says:

    I agree with your whole post except the one part. Your comment that profs couldn’t cut it in retail bugs me. In my opinion the profs that did the residencies and are making real clinical decisions worked a hell of a lot harder than those who got through pharmacy school and accepted the sign-on bonus from X pharmacy chain. I know this is a big source of contention for you, but I have no problem at all calling them “Dr.” At least at my school..aside from teaching, the profs are clinical pharmacists who do a hell of a lot more “pharmacy” as opposed to retail pharmacists who spend more time dealing with insurance issues. Many of them left retail not because they couldn’t cut it, but because they were sick of the retail experience and wanted to actually use their education. I’ve shadowed and had several experiences in the hospital with these professors and pharmacy residents who do have relationships with doctors and who actually make therapeutic decisions that the doctors listen to. They go on rounds and have full clinic days in addition to teaching. As if teaching is automatically the fall back option when in reality retail is the fall back option. They actually use pharmacy school knowledge…it’s not a “fart in the wind” to them. The teaching hospital that our school is a part of employs over a hundred pharmacists. It can serve as a model for what pharmacy could be. I know all this is not the norm by any means, but if pharmacists can’t even respect other pharmacists then how can we ever expect MDs to?
    Maybe it’s just my school, but my professors don’t sugarcoat the retail experience at all. They tell us how much they hated their retail experience and why. They tell us that it would be great to sit down and perform MTM, but the barriers are large. On top of that, The majority of our class has or has worked retail. We are fully aware of how shitty retail is in real life.
    As a response to Nicole…in almost all cases there isn’t time to sit down with patients. However with the integration of MTM and diabetes-ed services into certain retail chains and the new changes to Medicare D there is an opening for retail pharmacy to move towards allowing actual counseling to happen. Did you know all those techniques for talking with patients IS actually used in the clinical ambulatory settings? Soo…maybe it isn’t all BS. However, if we all as (future) pharmacists continue to keep saying that this will never happen and continue calling all of this BS, then it won’t. Maybe the reason doctors are so mean to you on the phone is because you’re a bitch. I’ve talked with and clarified scripts with more friendly doctors and nurses than assholes.
    I know I’ll get flamed for all of this by the retail pharmacists who read this for being too idealistic and for not even being out of pharm school yet, but I’ve seen what pharmacy can be. My retail pharmacy (that does over 400+ scripts a day) has MTM, diabetes ed, flu immunizations, and other counseling sessions that people pay for. I’ve seen first hand the impact and the role that pharmacists can play in the clinical setting. It CAN happen, but if we keep denigrating our own profession and our own colleagues it won’t.

  14. A CONNECTICUT PHARMACIST says:

    I think your point about knowing when to cut bait is the biggest hurdle for new graduates to understand. They used to teach business in school because each pharmacist expected to own their own pharmacy. That thought probably never crosses the minds of any new graduates. But somehow they expect to be paid as well as doctors, who usually own their own practice. Pharmacy is and always will be a product sale, never a service sale like a lawyer. It’s hard to understand when you leave the ivory towers, but everything a pharmacist learns in 6 years of school is given away for FREE. Only filling prescriptions, selling OTC’s and HME’s and yes, toothpaste, justifies a six figure salary.

  15. DrRx says:

    OK….
    First, I hope that when the pharmacy students post this in their schools, they also consider posting my response…
    1) The pharmacy school I went to never blew smoke up anyone’s azz about retail being wonderful. In fact, they were pretty damn adamant that it would be a waste of talent to go into retail after obtaining your PharmD. With that being said, before the haters start ranting about how I’m calling retail pharmacists the ‘bottom rung’, I’ll cut them off at the pass….. They were negative about the idea that a pharmacist was going to be able to make a living in the future by drug margin reimbursements alone and by basically doing the job that a vending machine could concievably do. You can disagree with this statement all you want…till your head explodes, till your spouse leaves you, till the kids sell you off to some nursing home…but the fact is indisputable at this point….. No one’s getting ‘paid’ anymore for dispensing prescriptions… I’d say a majority of the time TAP’s rants involve complaints about about making next-to-nothing by dispensing drug X to the patient (or less than nothing….at a loss)…. Let me ask anyone in retail (especially the independants), has this ‘sweet little deal’ of being the ‘middleman’ selling a product to the end-user got MORE or LESS lucrative over the years?! Show of hands??….wait, where’d all the independants go?…oh yeah…. bye bye…
    So, if you’re just getting into pharmacy school remember a few things. 1) It’s still a voluntary degree and free country the last time I checked…. No one’s being forced to go through pharmacy school…except maybe those kids with psychopathic, guilt trip parents with the money and preconceived notion that their kid’s going to become a Pharmacist if it’s the last thing they do….(gotta be a small percent I would think). Why do the commentors here seem to dissin’ their professors and the things their schools are doing to teach them their careers? Do you think that just reading a book and taking a quiz will make you a good pharmacist? Experience is great, and like TAP says, it can’t be duplicated in Pharmacy school, but you also need that didactic background to even consider taking it to the ‘next’ level. As what ‘some’ may consider an ‘older pharmacist…though no ‘gray-hair’ yet…the BIGGEST insult to myself and profession as a whole is seeing fresh graduates come out of pharmacy school dumber than a stump. They had better be able to impress me with some of that ‘book learnin’ or I won’t want to waste my time imparting any of the ‘gray-haired’ knowledge to them…
    2) Students: You’d better be hoping that someone’s ‘got your back’ (ie., those ‘corny professors’, their ‘ceremonies’, and those ‘nutty’ professional society ‘circle-jerk fests’) as far as your future in the profession of pharmacy is concerned and your strongest advocates are the school’s, professors, and professional societies (CVS, Balgreens and Spite-Aide can give two shits about you…especially if you don’t want to float for them for life)…. Those folks, unlike the retailers, really do give a shit about changing how the profession is perceived and they all have a bigger stake in your success. Otherwise, what in the hell are you doing in pharmacy school?! Get out while you can! Or so TAP would have you think… Do I think the professors are all spot-on, can-do-no-wrong gents and ladies….hell no! They’ve got faults too and there are some honest-to-god, nut-job incompetents too, but atleast there part of the process for figuring out how you’re going to be making a living 5-15 years from now when the social programs have finished collapsing under the weight of the baby boomers and there is no more ‘middle-man’ or ‘margins’……
    TAP…tell em’ about how reimbursements are already being calculated based upon average ACQUISITION cost minus 15% + $3.00 as opposed to the ‘golden egg’ we all know as AWP?
    Does getting paid for your knowledge sound so bad now (heck, and as a side effect, you get to keep that knowledge cause you’re actually usin’ it…go figure….)?
    My last comment…the one I’m sure will draw fire, is regarding the Birth Control Pill argument…. I am on your side that moral and religious believes should play no role in pharmacy dispensing… Refusal to dispense based upon those things goes against everything the healthcare industry stands for (do no harm, yada, yada)… But I must have read 15 comments you’ve posted over the past number of months that all relate some story of a ‘vicodin addict or loser’ trying to get an early refill or pull one over on you… Let me ask you…. What percentage of vicodin (or pick your drug…I won’t go the route of mentioning your personal favorite) prescriptions do you fill? Of 10 that you get, how many are legit in your view and you agree to dispense? Does someone’s appearance play a role in determining that script’s validity in your eyes? Some of your comments on the person’s smell, clothing, hygiene all seem to imply that you do…. Is that a ‘moral judgement you’re making’? One person’s street drug is another person’s morning coffee and cigarrette. The only difference is that one is illicit and therefore hard to get, and the other is has entire store chains devoted to it….(Starbucks…?)
    An interesting tidbit of real-life info for those pharmacy students out there… One of the sucky part of my job is having to monitor diversion in a large setting… We use many tools to do this in order to track patterns. I’ve ‘caught’ more than a few healthcare professionals with substance abuse problems helping themselves to the ‘candy store’…. Guess what?! It’s NEVER the guy/girl you THINK it is!!!!!! It’s always the one everyone LEAST expects…. The one that seems the most professional of the group, the most competent, the most liked by colleagues and patients, etc…. So what does that say about this country’s view of the ‘evils of addiction’? I’ll leave that up to your interpretation, but the view that many have about ‘impaired professionals’, in my experience, is a skewed one…

  16. Pharmacy prof says:

    Pharmacy professors can’t work retail? It takes an IQ of exactly 75 to work retail. It is YOU, my friend, that can’t do OUR job. Y’know, because we actually USE the knowledge and skills we have gained.
    Go back to dispensing your Vicodin, you glorified technician.

  17. Retail pharmacy survival guide

    Tips from The Angry Pharmacist.

  18. Lisa says:

    This is great! I’m sending a link to my sister-in-law pharmacist. She likes the work, except for the customers, the doctors, and the insurance. But other than those few distractors, she’s happy and has been doing this for 11 years.

  19. Pepperpourri says:

    Thank you very much for the list of advice, Angry Pharmacist :) It would be very helpful indeed if I ever worked in retail in the future. But that’s still quite a few more years to go.
    By the way, do you mind if I actually copy and paste part of this entry and post it in my blog? I would of course acknowledge that it is from your blog. Just thought I want to let my friends have a good laugh :)

  20. sabellaK says:

    I’m a pharmacy prof who couldn’t agree less with the one that posted earlier. Working retail effectively requires a personality type that I am first to admit I don’t have. I don’t have the patience to explain why copays have gone up and why I won’t fill an obviously early vicodin refill over and over and over again. Explaining math problems to a student sitting in my office, on the other hand, I can handle.
    I also don’t try to sugar-coat pharmacy as a profession, and I certainly don’t try to imply to my class that anyone can do retail. I’m rather appalled that apparently so many faculty members at various schools do this.
    Anyway, you’ve got at least one faculty member out there that thinks you’re great. One of my lab facilitators told me about you last year, and I am so glad.

  21. sergmeister says:

    Here’s a new one: Just got expelled from the Univ of Houston College of Pharmacy…6 weeks from graduation…last clinical rotation….$140,000 in total school debt… did I steal from the pharmacy? No. Did I curse at a nurse? No. Did I miss-dose a patient? No.
    I took a picture on my cell phone camera of my fellow student in a hospitals corridor and was dissmissed. No HIPAA violation. Was cooperative in every way. etc… Now I’m in a federal lawsuit with my school and Methodist Hospital in Houston, costing me thousands of dollars, losing hundreds of nights of sleep, and on the verge of “losing it.” Any thoughts or advice?
    my e-mail is serg_strango@hotmail.com if you have any personal comments, questions, or advice. Or if you’re sympathetic and have deep pockets; that would be helpful :)

  22. NJRph says:

    Your site is the funniest. I’ve worked in retail for 7 years before moving on, and I have to hand it to you guys, Chain retail is the hardest, most difficult out of all pharmacy careers.

  23. SassyTech says:

    Im glad you realize how valuable your techs are. Finally, someone who cares!

  24. Chris says:

    It is amazing how efficient pharmacy schools are at blowing smoke up your ass. I worked as a tech during my teen years, and I had a pretty good understanding of what the world of pharmacy was really like. Fast forward to my second year of pharmacy school and I’m a frickin’ zombie! MTM this and PharmD that etc…, and don’t even get me started on the clubs and associations! Now I’m five months out from graduation and doing my 4th year clerkships. I feel like I just woke up from a 3 year coma! What the hell just happened? Was I drugged? Did the professors release something into the air? Perhaps some type of mind control med? Were all those free food trays provided by Walgreens laced with something? I feel robbed. I want the last 3 years of my life back. Damned thieves!

  25. limari says:

    I presently work with a pharmacist who appreciates her techs the way you described. Where I work,(in LTC) most of us have been techs since dragons roamed the earth, so we’ve seen it all.
    And she is one of the few pharmacists we’ve encountered who considers techs her partners, not her underlings. Could that be one of the reasons we bust our asses for her? Yep.
    Thanks, TAP.

  26. sergmeister's classmate says:

    What “sergmeister” failed to mention is that he was using his cell phone to take a photo of a patient during a code. Doctors and nurses were working furiously to save this patient’s life (someone’s mother, sister, or wife), and “sergmeister” was callously taking a photo so he could have something “cool” to show his friends. How the hell is that not a HIPAA violation? If not the letter of the law, at least the spirit of the law. Do you want your mom to be in the hospital and some snot-nosed little dickless wonder photographs her while she is dying????
    The “fellow student” he claims to be taking a photo of? Well, she was standing BEHIND him, so he was between her and the coding patient. Of course, this all came out during out UH’s investigation and our professors didn’t buy any of serg’s bullshit. Of course now, the pathetic freak is suing our individual professors as well as the school.

    • joser says:

      At first when I read “sergmeister” blog, i felt very bad for him until I scrolled down and read sergmeister classmate’s claim of what really happened. That fucking prick is gonna get what he’s got coming to him. I’m a nursing student three months away from graduation with plenty of experience in the hospital and therefore serg’s classmates claim infuriates the fuck out of me. Who the fuck does that fucking fag think he is pulling out a phone and taking pictures like some queer during a code. If your bitchass is reading this “sermeister”, I hope you lose every fucking charge brought against you and hope you never receive your license to practice as a pharmacist. Your nothing but a shit stain on healthcare’s ass and I hope one day when your mom/dad is laying on a bed barely able to breath getting ready to die some fagit pharmacist is flipping through the channels trying to find something good on TV and afterward take a fucking picture of your mom’s corpse….fucking fagit.

      • KD says:

        The gay slurs are entirely unnecessary. You can insult this person that you don’t even know who allegedly did something you think is wrong without using language that is offensive to a minority. It just makes you and your argument look stupid and makes Sergmeister look all the better for it.

  27. Shackster says:

    Joser, be quiet stupid nurse, go away.

    Im sitting here, in the pharmacy bored outta my ass.

    I corrected two errors made by the doctor, where the doctor then tried making excuses up, thats lame and dumb.

    P.s. the errors would have resulted in severe morbidity if not mortality.

    No one gives a toss,

  28. Harmacist says:

    I worked for 7 different retail companies in my first 5 years out of school. I paid back two sign-on bonuses.
    I now work in a hospital and have done so at the same hospital for 8 years. Why?
    It’s interesting
    No insurance hassles or cash-handling
    Rare patient interaction
    Doctors take my advice about 90% of the time

    I would have slit my wrists had I not gotten this job and my only option was retail.

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