USA Today Article

So I believe I am the last one on this gravy-train of pharmacist bashing that the USA-Today is onto.  If you didn’t read the article (I barely skimmed it to be honest, its the media, and we all know they know everything there is to know about pharmacy and medication) it talks about Walgreens pushing their pharmacists to the limits, an error was made, blah blah blah.  I realize that the article focuses on overworking pharmacists in the chains, but I know that the shit thats splattering against the fan is going to trickle down to the independent level, so this bitch is sorta about mistakes in general.

If you read the article, it plays on the emotion of the poor kid who got the wrong medication, and the poor baby who got 5x the amount of amoxicillin and would ‘writhe in pain’ (give me a fucking break, a 16 day old baby isn’t even developed enough to know it even exists, let alone what pain is). Wah wah wah.  The kid probably was colic or had some gas and was fussy.

I’ll tell you first and foremost.  If you are a student, and have never worked in a pharmacy before, go work in one before you decide to continue any further with your career.  Retail pharmacy is high stress, no if-and-or-but about it.  If you do not take stress well, go dig ditches somewhere and stay out of pharmacy.  If you crack under pressure, or do not take interruptions very well, go sell shoes and do not go into pharmacy.  I don’t want my profession being drug through the mud due to you cracking and fucking up/going on a murderous rampage any more than it already does. :)

I’ll be up-front, if a pharmacist ever has said that he has never made a mistake, he’s a fucking liar.  Mistakes happen.  I have made them, you all have made them.  Be it the wrong strength (grab the wrong bottle), or the wrong drug but in the same class (dispense Zestril instead of Lotensin, brain fart), or you can’t read the fucking doctors handwriting (Hydralazine/Hydroxyzine, Lamisil/Lamictal, others that im too retarded to think of right now). 

Most of the times these are caught by your checking system, or the patient tells you that the pills look different.  Sometimes the patient mixes the bottles up at home, puts the wrong medication into another bottle, and blames you for it.

Now some math: If you make one mistake a day (which is huge), and you fill 300 rx’s, thats an error rate of %0.3.  Now if you make one mistake a week, and you fill 300 rx/day x 5 days = %0.06.  Now consider the fact that most phone-in Rx’s are by people who have zero medical knowledge and can barely speak English, or a doctor from India/China who can’t speak nor write English to save his/her life.  Throw in ePrescribing with adding technology to a technological illiterate profession with tiny mouse pointers and drop-down drug lists and you have yourself a class-A clusterfuck. I would say that pharmacists everywhere are doing a pretty damn good job keeping the error rate down.

This is all beside the point, the USA Today article blows autistic donkey ass.  Talk about a piece of shit written article.  Why don’t they do a fucking article about the Walgreen pharmacist who saved a life by warning the doctor that Mrs Jones was getting Amioderone from her cardiologist and her GP put her on Warfarin.  Or that idiot dermatologist who thinks that Doxycycline + Accutane is a good idea (go look up that interaction and tell me if thats not in left field).  Or the 100 billion drugs that causes QT-prolongation with Erythromycin. What about that 5 day old baby who’s life was saved because the fucking pharmacist saw the mother getting the pedicare liquid and told her to just put a vaporizer in the room instead of doping up the kid.  Oh right, that doesn’t get ratings so they don’t fucking publish it.

A pharmacist was overworked, fucked up, and now has his mistake published all over.  How do you think that makes him/her feel? Oh, it doesn’t matter, because a CHILD was endangered and thats more important.  Give me a fucking break.  Let the USA Today do an article about the hundreds of pregnant women who drink booze and smoke and how that TRAGEDY could of been prevented.  This shit is just like anything that has to do with guns, they only publish when some kid gets his head blown off for being an idiot and ignore the 99.5% of cases that they are used for self defensive purposes.

Fuck you USA Today.  I’m tired of your and the media’s sensational bullshit that you produce and spit out to increase your own ratings at the expense of the professions/lives of others.  Mistakes happen, and the first one that I made was going to your fucking website.

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28 Comments

  1. jen says:

    I’ve never been able to figure out why any person or system is expected to be perfect. People fall through the cracks, and mistakes are made, no matter which profession or system you’re talking about.
    But “blows autistic donkey’s ass” is now one of my favourite expressions ever.

  2. rph3664 says:

    ^5!
    I tell ANYONE who’s considering pharmacy to get a job in a pharmacy before enrolling in pharmacy school. I can’t get over the number of people who never work in one until after graduation!
    This advice applies to anyone considering a profession of any kind, no matter what it is. GET A JOB IN THE FIELD BEFORE YOU START STUDYING IT.
    The hospital where I work has had several technicians who did this, and realized immediately that pharmacy was not for them. They still work with us while pursuing other careers.

  3. hopeful student says:

    “Sometimes the patient mixes the bottles up at home, puts the wrong medication into another bottle, and blames you for it.”
    haha, our pharmacy’s favorite loony bin patient called me last weekend to let me know that her mother picked up her prescriptions that morning and that we only gave her 21 zyprexa….I check the computer, 2 prescriptions were picked up that morning neither of which were zyprexa…zyprexa was picked up 9 days earlier…SHE HAD BEEN TAKING THE MEDICATION, WE DIDN’T SHORT HER. she’s the patient you recognize the voice before she even says her name :(

  4. PharmD2B says:

    *thunderous applause*
    There was another part to that article/series, where USA Today presented 2 opposing opinions as to whether corporate policies increase a pharmacist’s propensity for errors.
    The person who argued they did was pharmacist who’d worked in the retail field for 40+ years and was a past president of the NPhA.
    The person who argued corporate policies are designed to decrease errors and help pharmacist was the 26 year-old son of a CVS supervisor, who has been working as pharmacist for all of 2 years. Get this- he only works 20 hours a week, though, because he’s in his /first year of law school/.

  5. wearyrph says:

    Well, mistakes do happen but we like to minimize that as much as possible I’m sure we all agree. Even with all the technology out there, if you have poor or no staffs, busy pharmacy, impatient customers wanting you to hurry, it is a recipe for disaster.

  6. RJS says:

    I go out of my way to avoid blog/newspaper stories that are guaranteed to piss me off. There was a time when I relished the feelings they elicited in me, but not anymore. I get enough of that in the pharmacy.
    And I agree with your sentiments 100%.

  7. Jimbo says:

    They’d really be upset if the knew the insurance
    companies are only paying about $1.50/rx over cost
    to guarantee mistake-free service. Sweet!

  8. Biggest Fan says:

    Okay – humans making mistakes isn’t new to me, of course… Physicans making mistakes is certainly not new to me – and is not new to the media. (Please don’t behave like you are God, but be perfect in medicine as if you were…) – Anyway…for you pharms out there…this IS new to me. What does this mean for you? When I google a drug, will lawsuits against pharms come up now? Are there malpractice suits against pharmacists? I’ve never really thought about this.

  9. PersonWhoReads says:

    Not to mention that USA Today is written at a third grade level. It’s not just the article about the pharmacist, that entire paper is seriouisly written for stupid people who want to feel smart.
    When I see someone reading a USA Today, I think, “Wow. There’s an actual stupid person.” I don’t need to talk to the person; the paper says it all.
    In my high school journalism class we were given copies of USA Today to show examples of bad journalism. NO JOKE.
    The media is evil — all of it. It’s all about ratings, brainwashing. Hell, they even elect the presidents. And it’s so easy for people to believe EVERYTHING they read, see or hear in the media.
    Maybe I’ll start a blog about how much I hate the media.
    You’re SOOOOOO right. You save thousands of lives over your career, but they print the one mistake.
    Well, *I* know you save lives.

  10. Beth says:

    The Angry Pharmacist is slacking this month. Must… have… more…. blogs…. more cowbell please :)

  11. bnm says:

    Question: simple example – doctors who frequently forget to write the dosage? or directions for warfarin/prednisone/valium? or write strengths that doesn’t exist? or mixing up mg-s with mcg-s? Is that a liability or nothing, just little fucking oops or what?
    And why patients letting it go saying to the pharmacist “well, hurry up call him, I can’t believe it…why it takes so long”

  12. B-N-M says:

    Question: simple example – doctors who frequently forget to write the dosage? or directions for warfarin/prednisone/valium? or write strengths that doesn’t exist? or mixing up mg-s with mcg-s? Is that a liability or nothing, just little fucking oops or what?
    And why patients letting it go saying to the pharmacist “well, hurry up call him, I can’t believe it…why it takes so long”

  13. indietech says:

    how about the doctors that give their nurses and RECEPTIONISTS the go ahead to write and sign prescriptions in the md’s name? the md never even checks them and we get to deal with crazy/nonexistant strengths and deadly amounts of oxycontin. no lie, we’ve had prescriptions written for 360 oxycontin 80 mg (that’s 80mg every 2 hours) that weren’t even signed by the doctor. yet when we call and complain he says to fill it anyway. now when that patient (who was a 26-year-old female with a very slender body that probably couldn’t handle that much oxycontin, assuming she’s taking it and not selling it) dies from an overdose, are we going to get blamed? or the freaking stupid doctor?

  14. Em says:

    I’ve been reading you for a while, and really enjoy your writing. I wanted to add that even though retail pharmacists do make occasional mistakes, am I the only person who feels like patients have some responsibility in checking that they get the right drug? I’m on a few, and find it’s not that intimidating to ask the doctor what they’re prescribing, how much, and what for, and to go ahead and open the pharmacy bag and make sure it’s what I was expecting. And if it’s not, they’re usually pretty good about fixing it, or explaining why the label says something different. So, yeah, I’ve gotten the wrong drug, or form of a drug (albuterol solution for a nebulizer instead of an inhaler, for example.) But I’ve never that I know of actually gone home with the wrong medicine.
    Guess I just have a personal responsibility thing.

  15. Just-A-Tech says:

    A patient brought this article to my pharmacy with the name WALGREENS highlighted in yellow throughout the entire article. He/She (it was anonymously dropped off – bitch ass customer) typed up a note and attached it to the front of the article saying, “Here is the recognition I PROMISED I would give your pharmacy. I hope the position of the article and editorials in this paper is sufficient for you.”
    I agree that we are overworked in retail. I agree that the stress level is high. I agree that we could use some more staffing. Do I think that if we had more staffing our error rate would drop? Not particularly. I worked in a brand spankin new store a couple years back to help open it and we had more STARZ reports from errors made by our staff pharmacists than any store I’ve ever been in. They got lazy, pure and simple. It just proves that the staffing isn’t going to fix the “problems” that that so called article explains.
    No where in that article did the reporter ever ask the parents of the child who received the incorrect dosing, “So Mr. and Mrs. Smith, when the pharmacy technician that took your prescription in asked you when you would be back to pick this prescription up; how long did you tell them?” My bet would be, “We need this prescription RIGHT NOW, the doctor said little Johnny needs this antibiotic in his system RIGHT NOW! IT’S IMPORTANT! WHY CAN’T YOU HURRY UP!”
    Or how about when (hypothetical situation) the pharmacist asked the patient, “I’m having a hard time making out the dosing, I’m going to call the doctor to clarify.” Mr. and Mrs. Smith hit the roof livid with anger that, “we were going to delay filling the prescription because we are QUESTIONING the doctor’s authority and knowledge and they are absolutely positive that the doctor told them that they were to give 1 teaspoonful once daily or maybe it was once at bedtime, either way it was one time a day and the strength was the more common strength, what strengths does it come in again? Yeah the 250mg/5ml that sounds right. Give us that.”
    Ok so yeah, this article has had me up in arms as well. I actually like Walgreens for the most part and I believe our safety measures are quite reasonable. In any company though, there will be good pharmacists and bad pharmacists, there will be good managers and bad managers, and there will always be bad techs along with the good(GREAT!) techs :).
    Thanks for your view on the article – it’s going to be one that’s given to my pharmacy manager so she can see we’re not alone in thinking this customer was a dipshit!

  16. E says:

    Only one teeny comment…babies do feel pain. Maybe not the way you and I do, but they definitely feel pain. My son was in the NICU for a month when he was born, and he was definitely hurting with some of the procedures.
    Other than that, no arguments.

  17. GC says:

    I completely agree with you on this TAP. Where are the articles praising the pharmacists for catching the millions of errors DAILY?? Its such bullshit, i mean its never good to make a mistake but as humans we can only be so perfect. we all do our best to make sure that the medicine leaving the pharmacy is accurate and a safe dosage…its not like we TRY to fuck up. stupid usa today. Keep it coming TAP!!

  18. Pharmacist2B says:

    First of all, love the rants. I tell so many people about this site, I feel I should be charging a finder’s fee :) But on to the good stuff. I definitely echo GC’s ending sentiments. It bugs the shit out of me to hear people bitch about pharmacist mistakes. I know we have all worked with a relatively incompetent pharmacist. Like all professions, some people just aren’t cut out for the job. But the vast majority I work with are very good at what they do, and extremely accurate. As has been said already many times, mistakes are inevitable. What I absolutely hate are the absolute assholes that treat each mistake as if it were a malicious act. As if the pharmacist were trying to do them harm. Personally, I have targets about whom I occasionally daydream of doing just that (these get me through the tough days :), but I’m pretty sure I could find a better way of doing it than accidentally mistyping the number of teaspoonfuls of amoxicillin they should be taking. And as always, these same assholes are the ones demanding we fill their prescription in the five minutes it takes them to cram a box Ho-Ho’s down their fat coated neck. Can I get an amen?

  19. TheDruggist says:

    Yes, we all have made mistakes. Isn’t it funny though how most of the time its the minor mistakes that people get the most pissed about. Dispense Coumadin instead of Claritin, patient says no biggie, shit happens. But dispense the right drug but forget to put on the easy-off old-fart vial lid, or type the wrong dr. name on the rx and the patient wants to chew you out. Strange……..

  20. rosesinjanuary says:

    I have no argument with the fact that all people make mistakes on a daily basis. Or that the expectation that anyone in a medical field must somehow be perfect and avoid all error is both foolish and impossible.
    I do have an argument with your implication that newborns do not feel pain. Even premature infants seem to feel and respond to painful stimuli. You might want to read the classic article by Anand in New England Journal of Medicine from 1987, page 1321. http://www.cirp.org/library/pain/anand/
    or read the American Academy of Pediatrics policy on neonatal pain. A revised version was released in 2006. http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;118/5/2231

  21. rph3664 says:

    Thedruggist, you are right about the error thing! Also, people who really are sick rarely cause trouble; it’s the people who probably have a million dollars stuffed in a mattress somewhat who are the biggest PITAs.
    JMHO.

  22. PatTheStaffPharmacist says:

    I’ll never forget the night when an abx script was dropped off for an infant that the dose was BLATENTLY about 6-7x what was considered safe by both me and the package insert. I told the mother (whom had waited until 830 PM to bring the script in – she had gotten it about noon) I didn’t feel comfortable filling it without first discussing it with the physician. She flew off the handle and asked me WHO I was to question what the DOCTOR had PRESCRIBED. I told her it was my very JOB to question it and I would not fill it until I spoke with the physician. Her husband was the one who finally stepped in on her chewing me out and got her to leave and allow me to make the call the next morning, and it was the husband who then came in alone to pick it up, eternally grateful to me when the MD reviewed what she had written and discovered the error in her weight based calc and thanked me ever so much for catching it. And it was her husband who apologized to me on his wifes behalf for catching it and saving their child from harm. I never saw that woman again…

  23. Vtech says:

    OK. I read that article also. I’ve worked in a pharmacy for about 3 years now and this is what I’ve always wondered. If I was the patient and I picked up a rx that was filled for the wrong drug and blindly took the medication, who’s fault is it? Mine for being stupid and not checking the bottle or the pharmacist’s? I mean don’t we all have some responsibility towards our own health and safety? A couple of months ago a woman picked up amoxicillin suspension for a baby from our pharmacy and the tech who rung her up forgot to mix the medication. So this woman gave the baby a teaspoonful of POWDER ..yeah powder. She came back to the pharmacy the next day with the attitude that we tried to kill her child ..but she did nothing wrong. WTF? I mean would you not atleast call the pharmacy to ask why it’s in powder form?
    How about the man who kept taking Clarinex for two months not realizing it was his son’s medication, but because they both share the same damn name it was OUR fault that he did not take his blood pressure medication for two months. HE kept picking up his son’s refill and calling it in but it’s OUR fault. Oh yeah, we feel very guilty.

  24. Kelly says:

    I’m not a pharmacy worker nor a pharmacist and I read the article differently. I read it as an indictment of big chain stores that press for more and faster rather than pressing and measuring quality. I saw it as a black mark against the _corporation_ not the pharmacists.

  25. Pharmsoldier says:

    I didn’t see the article, but do think the practice of pharmacy is poorly understood by the public. We all know it’s for more complex than pouring “pills” from a big bottle into a little one. “…sucks autistic donkey ass…” is fantastic description of many things. May I use it?

  26. Rio says:

    I want to say thank you, to you and all the other pharmacists, that catch doctors’ mistakes, advise people on OTC stuff that can cause more damage than anyone realizes, and help someone figure out why they’re reacting to their medications.
    I have heard way too many friends tell me that they were having serious health problems until they took the medication bottles to the pharmacist and said, “Help me, this is what’s going on,” and the pharmacist said, “Well, here’s why,” pointing to the culprit medications–after trips to the GP, cardiologist AND pharmacologist resulted in no help.
    I am also grateful to pharmacists who talk to me about new medications, to make sure that I’ve been prescribed the right one (preventing Lamisil/Lamictal type mistakes), or discuss with me the possible side effects to look out for when a dose has been increased.

  27. intern2010 says:

    I have to say that I’ve seen or heard of patients getting sick from medications they were taking and then bitch at the pharmacists and/or try and sue the pharmacy for not “catching the mistake” when it was the patient’s bloody fault in the first place. They didn’t tell us they were getting all sorts of other scripts from 3 other pharmacies because “it’s cheaper” or the whole transfer and get a gift card deal so that no one knows what they are on and they refuse to tell you.
    I also think the article is a crap. There whole series on Rx errors seems to point out how bad pharmacy seems to be doing, not how many lives are saved because of pharmacists catching these errors or catching duplicate therapies. I also didn’t care for the idea that a pharmacist has to stand at the checkout asking every single person “do you have an questions for me”. This is great if the pharmacy has the staff and is slow enough but when you’re backed up, it doesn’t make sense to ask the person who’s been taking the same medication and dose for 10 years if they have any questions. I like the way NY laws run and that all new scripts must be counseled on, it may piss some people off but I’ve seen alot of questions suddenly brought up that way. Simple things like the patient didn’t know not to take the doxycycline with dairy.

  28. http://openid.aol.com/CoolKitten72 says:

    Great post, thanks!

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