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.
- Paying the PBM’s to service them.
- Im dreaming of a Crackhead Christmas.
- SOMABOTS, TRANSFORM!
- A pharmacist example for non-pharmacists.
- Trying to not kill your patients.
- An open letter to my patients.
- The FDA obviously hates the public and needs to lay off the crack pipe.
- How to make your pharmacy career less painful.