A profession of fighting

Has anyone but myself noticed how pharmacy has turned into a profession of nothing but fighting?

  • Fighting patients: Early refills, lost medications, the lies, the bullshit, “Do you have any other insurance cards?”, “What do the pills look like again?”, “There is no way you should be out of those yet!”, “Who told you to double up, and why didn’t you let me know!”, ARGH!!!  It seems like no matter who walks into the store its going to turn into a stressful conversation.  The happy patient who brought their refills in on-time with a smile on their face and a compliment are long gone.  Patients are the number one stressor in any pharmacy.  From bitching about copays (that they think we set) to the pills looking different, they are both the boon and the bane of pharmacy.
  • Fighting doctors/staff: Cheap front-end staff, people who cant call in medications correctly, sloppy handwriting, ignorant doctors and their drug-rep propaganda, the list goes on and on.  Most doctors are pretty good about listening to what we suggest (because they know they really have no choice) but it takes a fight with one to ruin your day.  “Yes, doctor, EVERYWHERE is short on generic Toprol XL” to “Are you sure you want Soma 250 or that new Prevacid???” at least doctors are mostly on our side.  Fighting with the office staff is more of a problem, especially the ones who think they know as much as the doctor (“No, I want this!” when the doctor says “I dont care”) when in fact they know nothing.
  • Fighting insurance companies: If there was a top-10 list of places to blow-up before you die, I’m sure that every pharmacist would have insurance companies as numbero-uno.  Shitty contracts, reimbursing below cost, unavailable products, rejects, wrong shit on insurance cards, mystery person codes (like person 88), prior auths, “Plan Limitation Exceeded”, quantity limits, sig limits, day supply limits, limits on the limits on the limits, this list never ends!!  It costs a pharmacist $1/min to stay on the phone, it cost the insurance company $3/hr (if that) for that Indian call-center person to answer your call.  Who do you think is getting the deep dicking on that deal?  Fighting with automated systems which require you to say your NPI number 4 times to be transfered to a live person who requires your NPI another 2 times.
  • Fighting other pharmacies: Waiting on hold for a transfer for 10 fucking hours or calling every place around town to see if Cracky McCrackhead is doctor shopping.  Pharmacist doesn’t speak english/is too busy to talk to one of his own/is off for lunch/the list goes on.  Yes, it does take 4 hours and 2 phone calls to get that copy faxed over.
  • Fighting technology: The fax machine jammed, the printer needs a new fuser, the pharmacy software crashes randomly as you feel like you’re talking with an insurance company when you call your corp help desk.  Some days when the shit rains it pours.  You hit your coffee and dump it into your keyboard or some tech sneezes all over your monitor you wish you could just crawl in a hole and die.

At the end of the day, when you sit down for the first time in 9 hours, you realize that it all is just going to repeat the next day.

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92 Comments

  1. LucyVanPelt says:

    Here is a classic. Patient has been on Omeprazole and Plavix for several years. Due to new possible interaction, Express Scripts will not pay. I call MD. Plavix was stopped by cardiologist 3 weeks ago. I call insurance co. thinking this will be an easy fix. Oh, NO! MD must call in a PA for a medication that was STOPPED?!?!? or switch to generic pantoprazole or an H2-blocker. MD, of course, doesn’t want the headache of doing a PA on a medication that the patient isn’t taking…So he writes for Protonix. Guess what? Pantoprazole is non-preferred. It, too, requires a PA. WTF!?!?!? The rep, as stated by you previously, didn’t have the greatest command of the English language. Asked to speak to PA dept. and/or supervisor. Never did get it resolved. You are entirely correct. They are at the top of my list of places to blow up.

    • Jane says:

      You say exactly how I feel every day working in the pharmacy. Its so true and then it all happens again the next day.

    • Sherille says:

      Haha you’re right on the money

    • 10yrrph says:

      Why do pharmacists put up with this bs. I would be looking for another job instantly. I lasted 6 months at retail. I really did not see a point to my job. I took another job consulting. Rph’s there are better options out there than retail bs.

  2. Phat says:

    I try to tell people just starting out in this shit that eventually, one day you’ll get home and just want to pull you’re fucking hair out. Everyone seems to have this idyllic notion of what working in a pharmacy is like.

    In reality it is a daily clusterfuck in which you get raped up the ass by various individuals several times of the day. There’s really not one point any more when you can take a breather and get caught up with your feelings in such. It just keeps coming and coming and coming…

    Thank God for alcohol

  3. Ron says:

    if i agreed any more with both of your posts i would be you. bravo!

  4. VulgarFoulBastardPharmacist says:

    Fuckin ayyy! What a big fuckin turd it has all become the last decade, specially the last few years. Fighting within your own organization. Fighting with a bunch of no degree bean counting dickholes. Fucking fuckers. No I don’t mean that in a good way. Fucking asshole people I must interface with. No more next year when my sentence is up. Fuckers. You all make my stomach churn acid. Why can’t you all just do that which is good and right, well and cost effective? Motherfuckers. Die before me. Fuck you. Have a nice day, interfering cockbite.

  5. Georgia RPh says:

    Amen, brother. On the one plus side, I’m so tired of fighting by the time that I get home that never fight with my husband. It just isn’t worth getting in one more fight over anything when I know in 12 hours I have to go back and do it all over again.

  6. ZooPharmer says:

    Very nice tell-it-like-it-is post. Some days I just walk out the door thinking to myself – “This just shouldn’t be this difficult.”

  7. Sibyl says:

    I had a great experience at a pharmacy today, so I’d like to give you and yours a pat on the back.

    I am on vacation. Before I left, I checked all my medications and had my doctor write out a refill for one of them so I could fill it when it ran out. I packed the prescription in my medication bag and took it with me.

    I pulled out the prescription today to notice two things:
    1) My doctor had written a three month supply, as asked. But he had written it as 180 pills instead of 60 pills x 3 refills. Ugh.
    2) He had incorrectly written it for a higher dosage of pill than I normally take. I take 0.5mg of Klonopin and he had written it for 1mg pills.

    The pharmacist was extremely helpful as I explained the details. I had brought my pill bottle with me to show them the normal dosing of my medication. They told me they could do a partial refill, no problem, and though they had to give me the dose that was prescribed, I could just break them in half. Again, no problem.

    I told them if they were super busy I’d just come back for it at another time, but they said it would only be 15 minutes. They had it ready for pickup in exactly 15 minutes. I had a week of Klonopin left, so it wasn’t a super emergency, but I am glad I did not have to spend that week trying to call my doctor to get him to call in a corrected prescription to the nearest pharmacy.

    Pharmacists who can think on their feet are truly awesome. The pharmacy tech was also very cool and accomodating. Nobody treated me like a drug seeker or a bozo for not noticing the mistakes on my prescription before leaving. Maybe they were new to the profession? Then again, how often do you get a patient in the pharmacy who complains the doctor prescribed *too much* Klonopin?

    Thumbs up for pharmacists! They’re always nice to me and I never have to fight them. I hope they don’t have to do too much fighting with my insurance company or my doctors on my behalf behind the scenes.

  8. Dante says:

    “you wish you could just crawl in a hole and die”

    Nice. But seriously, i’ve never had a day where all of these problems hit on the same day. I just munch on a chocolatchip muffin during the day. keeps me happy.

  9. JL says:

    This is one hilarious post. Especially about the insurance companies as a top 10 destination to blow up. It has to be higher on the list…maybe top 3 or 5. Then, TAP, you can start the F&^C You to some other insurance besides Health Net.

    As for the fighting patient: too bad you are not allowed to pepper spray them to get them to shut up. If it was legal, those pepper spray companies would have a new business avenue to pursue. Maybe they should send a lobbyist to legalize pepper spray on fighting patients!

  10. MB says:

    I agree with the whole list. Number one on my list is the insurance companies then customers and office staff tying for second. I’ve worked wtih some great docs and their staff and some really shitty ones. One office has a very long IVR system and every option to acutally speak to someone gives me a voicemail or the receptionist who will fail to pass on the message correctly if they do it at all or they just foreward me to the voicemail anyways and I never hear back from them 99% of the time. Patients also seem to think that it’s perfectly okay to wait till friday at 6:50pm to come in and say they are basically out of insulin with no refills left and want us to call the MD to get more or just hand them a couple of bottles of lantus for free.

  11. Katy says:

    You completely forgot to mention nursing homes. Holy shit. x_x

  12. Drug Monkey, Master Of Pharmacy says:

    Reading LucyVanPelt’s comment, I can’t help but to think to myself:

    \Well it’s a good thing we don’t have government run health care in this country, otherwise really fucked up pointless bureaucratic shit would happen\

    But back to your actual post:

    \If there was a top-10 list of places to blow-up before you die, I’m sure that every pharmacist would have insurance companies as numbero-uno.\

    So…..why exactly would you not want a public insurance option to compete with the places we all so desperately would like to see blown up?

    Don’t think a public insurance plan would work? I’ll believe you when you tell me you were able to walk into FedEx and have them send a letter for 44 cents.

    Oh, by the way, you know who doesn’t have to worry about all the shit private insurance companies put us through?

    Canadians

    and people from the UK

    Germans too.

    Not to mention Japanese, Australians, the French, and pretty much everyone else in the industrialized world.

    And they spend a lot less than we do. And cover everyone.

    You’re getting taken for a ride, sucker.

    • Alberta71 says:

      Actually, we get some insurance bullshit in Canada too, albeit not as much hassle as you guys have down south. We deal in Alberta with about 10 or so plans. You have the majority being plans through work, and you have some government plans, ie) senior, social services (like Medicaid, etc) you have Veterans (but that is dwindling!). These are online realtime plans, at my store, We DO NOT do anymore paper billing, ie) assignment billin….it doesn’t work in our computer age. It’s like having them write you a cheque,just plain dangerous, so no Workers Comp for us, Hurray!!! But, I spend about half my day dealing with insurance issues, but I am getting wise, if it rejects, I just make the customer pay cash, and then they can deal with their own plan later!!! Our students are always surprised buy how much time we spend on the phone with insurance, Not with MDs!!!

  13. Mike says:

    @ MB – You’ve noticed that, too, about the insulin? Is this something they’re teacing in diabetic classes? “Insulin is the freshest late on a Friday evening — wait until then to get it! When you’re told that you ‘have no refills’, just turn your head to the side, make a weird face, and say ‘I’m a DIABETIC’. The Pharmacist will be glad to track down the Dr.!”

    Another thing I’ve noticed in my 10ish years of practice, is that the people who get the huge supplies of insulin (15-18 vials of Lantus/Humalog — invariably something expensive) LOVE to order it on a Friday, knowing FULL WELL that I won’t get another order ’til Monday and will have to partial everyone else all weekend. I cannot remember the last Friday that this DIDN’T happen.

    (TAP — sorry, I know this is a bit off topic, but I guess it kinda goes along with “Fightin Patients”.)

  14. vga says:

    Great list.

    You forgot fighting with district. It’s summer – cut hours. It’s winter – cut hours. It’s arbor day – cut hours. By the way, institute this new obnoxious company policy. And I got three complaints about you not refilling Cracky’s Percocet.

  15. FrustratedTech says:

    You forgot one (maybe since you have a get-out-of-jail-free-card on this one, being an indy):

    Fighting the Grocery Manager: It’s THEIR STORE dammit. And pharmacy is EXACTLY LIKE GROCERIES and can be managed 100% the same. They’re the FRICKIN STORE MANAGER and they worked long and hard (dammit) to get there, so they’re just too important and busy doing super important things like sweeping or making sure those beans cans face label-side out that they just can’t spare a SINGLE MOMENT to listen to a word you say or do trivial things you need done – you know, like hiring a new tech because one quit three weeks ago (after two weeks notice) and another is leaving in a month. UNIMPORTANT! THOSE LABEL *MUST* face right-side-out or the store could face losing PENNIES!! Oh WAIT, the register was off by TWO DOLLARS six weeks ago! YOU HAD BETTER TELL HER *RIGHT NOW* DAMMIT WHERE THOSE TWO DOLLARS ARE! I bet one of the techs stole it! (You know, because you can trust them with hundreds of thousands of dollars worth of drugs, but they MUST have stolen two dollars from the register!)

    What do you mean that treating Pharmacists and their techs like a herd of coconuts doesn’t work?

    • hatemyjob says:

      SO i made the mistake of being honest today.
      -Lady calls and asks is her prevacid(emergency emergency!!) is ready.
      -I look in the computer (which only makes my life harder) and say, “oh, looks like we’re finishing it up right now.” (it was in “product dispensing” and I could have it ready by the time I hung up the phone)
      -SHe says: “WHAT!?? They said it would be ready yesterday!”
      -So I respond: “Well, it’ll be ready by the time you come up here, so whenever you want to pick it up will be fine>”
      —-I get the stupid prevacid ready—–
      5 minutes later, the store manager comes over and asks is it ready….I TOLD HER THE FUCKING PRESCRIPTION WOULD BE READY WHENEVER SHE WANTED TO COME PICK IT UP!!!

      Then, the real kicker, this bitch is an employee of the store! I mean COME ON! These people need to get a freakin life!!

      I CAN’T BELIEVE I OWE PEOPLE 45K IN LOANS FOR THIS SHIT!!

      • DDH Pharmacist says:

        Yup! Sometimes other employees in the store are the worst.

        Of course, I do love having the ability to kick any manager (store manager, assistant manager, or any other person) out of the pharmacy.

        Been there, kicked out my fair share of managers. It is fun! And when customers want to complain to the management about something we may or may not have done, the managers at the store I work at come and ask us what happened *before* they really respond to the customer!

        I think our store management folks are reasonably trained. They ask before they enter the pharmacy. If no one who works in the pharmacy recognizes you, you’ll get questioned. At least the “Who are you, and why are you in my pharmacy?” Which I think annoys the sh*t out of a lot of members of management.

        Even the new store manager asked before he came in the pharmacy the first time. That was nice.

    • Bill Bidwell says:

      I have wonderful techs that work their butts off! The frickin’ deli gets more respect than the techs !!! It’s a ‘World turned upside down!”

  16. Phat says:

    Actually, move insurance companies to the top of the list.

    The shit Medco is pulling right now is the biggest pussy move in the history of pharmacy. If I had one gun, with one bullet, I would find the CEO of Medco and pop him in the head.

    They are setting an incredibly bad precedent and, much like the $4 generics, it will most likely catch on with others.

    And then we’re really fucked.

    • Kay says:

      Phat

      What is Medco doing? I hate them too but don’t know what youre talking about. If it’s something we can fight, let me know what it is. We don’t need any new precedents set.

      K

    • JP says:

      I couldn’t agree more. Yesterday I literally drew a picture of myself gunning down the Medco CEO while I was on hold for 40 minutes (no exaggeration) only to be told that their computer system can’t transfer a valid prior auth to a new id# for a special needs patient. (Seriously? I’m pretty sure my Apple 2E was capable) And I loooove they way the call center reps just read words off a screen and don’t even listen to what you’re saying. Thank god for Tanqueray and tonics.

  17. pharmacyslave2000 says:

    Drug Monkey, please go back to your own blog and shovel your “socialized medicine is health-care utopia” bullshit on the clowns who suck your dick on your site. Anyway, I couldn’t agree more TAP. The ONLY reason I continue to do this job is money. Because I need it. And alot of it. To pay off the obscene amount of student loans I owe. The general public have no idea about the shit involved with this job. They simply see how much money we make splattered all over Yahoo about once a month. Every job is stressful in its own right, but any job servicing the ignorant general public steps to the front of the line. Keep up the good work TAP.

    • Drug Monkey, Master Of Pharmacy says:

      Pharmacy slave,

      You know who doesn’t graduate college with crippling student loans?

      Canadians.

      You got fucked and then you thanked them my friend. You actually continue to suck the dick of the people who fucked you to this day. It would be hilarious to just sit and watch you felicitate them if you doing so didn’t mean they expect the same from the rest of us. Please stop.

      • Nancy says:

        Just to let you know, I’m a recent Pharmacy grad in Canada and I am definitely “crippled” by ridiculously high student loans. A word of advice: it might be worth informing yourself before posting comments. This is for your own good though.. I’d hate for you to be perceived as ignorant.

        On a separate note, I have to admit that I don’t think we have quite as much difficulty with insurance plans here in Canada as you do down there, however I do have the daily fight with third party insurance.. and patients complaining that “the government covers all my heart medication.. how can they NOT cover my cialis?”

        • Drug Monkey, Master Of Pharmacy says:

          Whatever my weaknesses Nancy, ignorance is not one of them. A Canadian can expect to pay about 40% less to go to college than a student south of the border. I suspect your definition of crippled may be a bit different than Pharmacy Slave’s.

          • Jeff says:

            Why don’t you tell everyone the other half of the story? You know, the half that would explain why Nancy is crippled with debt and why your “40% less to go to college” fact doesn’t mean shit. It may be true that a Canadian can expect to pay 40% less to go to college, but Canadian pharmacists can also expect the average pharmacist’s salary to be approximately 42% less than what an American pharmacist makes.

            • OUT FOR LIFE says:

              Holy Cow Jeff, maybe that’s why the rest of the industrialized world pays less for health care, because another part of the other half of the story is price controls. Funny, how they keep cost down, but they also deincentivize the market. Name me one big Canadian innovator drug company. There isn’t one because there is no incentive to invest. Colleges cost 40% less in Canada. Tell me the last time you heard anyone mentioning a Canadian University in the same breath as MIT, U of M, or any other U.S. Universtiy.

              • Drug Monkey, Master Of Pharmacy says:

                I feel like I’m butting in Out For Life, because it kinda looks like you want Jeff to name you a Canadian innovator drug company. I really don’t think he has the intellectual firepower to do it though, so yeah, I’m gonna butt in.

                Actually, now that i think of it, I can’t name a Canadian innovator either. Crap. Although the story of how the Canadian company Apotex took innovator pharmaceutical company Sanofi Aventis to the cleaners with a short lived generic Plavix is one of my favorites.

                Sanofi is based in France by the way. You knew that though, right? Because you’re so knowledgeable.

                I bet you also know that GlaxoSmithKline is based in that den of socialized medicine, the UK, right? Of course you know that, because you’re such an expert on which economic systems produce innovation.

                Astra/Zenica is based in both the UK and Sweeden. Boehringer Ingelheim in Germany.

                So since you knew all of this already, it would seem that what you are saying is that the problem with Canada is that they don’t have *enough* government control over their health care system. That’s pretty radical there Out For Life, especially since all President Obama has proposed is a public health insurance alternative to compete with the Medcos of the world. I think you’re too far to the left of me my friend.

                Oh, and McGill University in Canada consistently ranks among the world’s best, while that den of socialism, the United Kingdom, puts three Universities on Newsweek’s ranking of the world’s top ten. Not bad for a country with about 20% of the population of the US.

                Those would be facts, Out For Life, not feeeeeeeeeelings. Learn the difference before you get bitch slapped again.

                • OUT FOR LIFE says:

                  Hardly, with regard to bitch slapping. All of those companies were founded well before socialized medicine was commonplace in the countries of their origin so your argument is not logical. Furthermore, most of them have major subsidiaries in the U.S. for tax purposes. In a more dramtaic fashion, Bayer moved its world headquarters from Germany to New Jersey for tax reasons. Europe has little if any new developing major corporations and had negative economic growth even early in the 2000’s. The government takeover of private markets destroys incentives and lead to excessive taxation which in turn reduces individuals’ abilty to participate in the economy while destroying the prospect for business profit which removes any desire to go into business in the first place.

                  Noone starts a business to pay the government taxes. They start it to make a profit, socialized programs kill these profits.

                  By the way the UK is currently considering to switching to an HMO system because shock, their socialized system isn’t working.

  18. 2BAPharmD says:

    DrugMonkey,

    Since everyone else is ignoring your post in here, I’ll respond to it with an anecdotal experience from last week. Usually, I use FedEx or UPS because I really hate dealing with the government unless I absolutely have to. And this really firmed that up in my mind.

    My wife and I were at the post office trying to send a Sony e-Reader to a friend in Michigan who was leaving the country on business and needed it. Not urgently, but in a few days. We went into the post on a Thursday, and waited for 53 minutes in line (Since they only had one employee… And 9 open, vacant spaces for other employees). The entire exchange was akin to pulling teeth without Novocaine.

    First, we asked the incompetent moron when the package would arrive. She would say, “Priority mail is an estimated delivery of 2-3 days.” OK, in your professional opinion, Miranda, if it goes out today, is it a reasonable assumption that it’ll arrive by Tuesday? “Priority mail is an estimated delivery of 2-3 days.” Okay, seeing as how they’re on a broken record, we say forget it, and spring for the next-day-air certified mail because my wife REALLY wanted to make sure the e-Reader arrived at its destination, Grand Rapids, MI. So we cough up the cash, the really grouchy Miranda affixes 900 stickers to our box and hands us the receipt. Half way home, my wife notices that the idiot put in the ZIP code for Ann Arbor, MI.

    I promptly flip a U, and fly back to the USPS. Lo and behold, Miranda is on lunch, replaced by another bitter federal employee. She told us, in her professional opinion, that the package is just going to Ann Arbor en route to Grand Rapids.I try to explain the not exactly insignificant distance difference between GR and AA, and she insists, again, in her best “I’m second in command ONLY to the Postmassssterrrr” voice, that it’ll be fine.

    We didn’t believe her, and requested her to do what she could to repackage the item and re-send it, or “zero it out” so it arrives where it needs to. She looks in the computer again, after about 15 minutes of nagging…. And a little light bulb pops on over her head. “Oh… wow… I guess I’m wrong.” No “Sorry!” nothing. “I GUESS I am wrong.” SO how about tossing us a spliff, like 1/2 off shipping because you nearly sent our package to the wrong end of Michigan while insisting you’re right like an idiot? Nope, sorry, federal law prevents that.

    You know what, that would NOT happen at the UPS Store. Employees at the USPS are RUDE and they know they can get away with it. They’re lazy, entitled, and just don’t give a damn. Why? Because they’re in business whether we like them or not by the nature of bearing the mantle and might of the federal gov’t.

    The UPS Store and FedEx simply can’t do that, and thereby maintain better service standards. A BUSINESS is not in business to lose customers, but a federal business could not care less about it. The wheels of government will still turn. Imagine a department store run by the government… Merchandise would be everywhere, disorganized, and the employees would be taking smoke breaks every 5 minutes. The items would be labeled “Sock, left foot” and look the same. They’d provide roughly the same service on paper, as say, Dillard’s…. But the execution would be utter TRASH. Because human beings WILL get away with being lazy when, and every time, they can.

    Bottom line is that America is NOT Germany, Sweden, Norway or any other country you socialist-lovers like to point fingers at as being panaceas to the epidemic. It would not, and will not, work in America. Our system now is ailing, yes indeed it is. But allowing for even less accountability and even more laziness on behalf of the health care industry is not what we need.

    Your example, Drug Monkey, of the USPS’s 44 cent letter is accurate though. You’ll pay less, sure, but think of the service difference over all. You get what you pay for.

    • Drug Monkey, Master Of Pharmacy says:

      OOOOOOOhhhhhh….an anecdote. Well that proves everything!!!! Why did I spend all that time tracking down actual NUMBERS and FACTS when I could have just written a little story about how my mailman will deliver my packages to me at the store when I’m working because it’s on the same route and he’s a good guy? Hell, I could have saved so much time.

      A story that would be true by the way, but that would not prove a thing.

      Thanks for wasting everyone’s time numbnut.

      • 2BAPharmD says:

        No need to be rude.

        Customer service is not quantifiable with numbers of facts, DM.

        The fact of the matter is, private businesses are obligated to provide excellent service, or they lose customers (or get fired, from a cashier/managerial level). Not so at a post office, airport, or anywhere else.

        You will greatly sacrifice for government run health care. In the Army, we had health care run by the government… And it was horrible. The doctors were overworked and didn’t care much about the patients, the receptionists would lose appointment slips and such, and there was no way to complain or anything, because hell, Uncle Sam runs it and he’s beyond reproach.

        I’m a very loyal reader of yours DM and I resent the insult. You always insist people have an open mind, but yours is seemingly QUITE closed about this. YOu’re looking at only one side of the issue – The monetary aspect. You have to realize that, if a hospital is going to run like a USPS, overall QUALITY of human interaction WILL decrease.

        Been to the DMV lately, Drugmonkey?

        • Drug Monkey, Master Of Pharmacy says:

          There is a need to be rude. Because you are a fool, and I don’t suffer fools.

          Yes I have been to the DMV. Have you called an insurance company helpdesk of late?

          Or another pharmacy for a copy?

          For the second time numbnut, anecdotes are not evidence, and if you wish to stop being insulted, than I would suggest you learn this. If you are a loyal reader of my blog, than you should have seen more than enough actual evidence to have an idea what the difference is.

          Repeating myself again, thanks for wasting my time. I have a feeling people repeat themselves a lot with you.

    • Phat says:

      The only reason it ‘would not work’ in America is because our citizens are lazy and unimaginative bastards. Yes, I said it. If it requires a bit of thought and, God forbid, some personal difficulty, than we don’t want to do it.

      Personally I have lived in three major cities and never had a problem with the USPS and have had more problems with UPS/FedEX.

      Here’s another ‘ancedote’ for you, do you realize in countries with non-federalized postal systems that it can be a virtual crapshoot if your package will actually arrive? Many of them couldn’t guarantee 2-3 days if their life depended upon it. Yet our USPS can do just that. Maybe they can’t give you the exact day and time like you wanted, but it would be there in 3 days. If it was such a big deal, why not over night it? Or maybe ship it in any other way but priority since that is the least reliable method of shipment.

      You ever think maybe the employee thought you were a dumbass for wanting to have this package delivered at a specific time, but weren’t sending it in the proper method?

      • 2BAPharmD says:

        It was a simple question – Will this package arrive by Tuesday? This does not require a guarantee. I did not require the employee to say, “Without a doubt, this package WILL arrive by Tuesday!” I asked, in her professional opinion, if it’s likely that it will.

        Once we realized she was incompetent and couldn’t think outside of her little government script, we paid for the next-day-air service. I don’t work at a post office, and I am not an expert in how long things take. They say 2 to 3 days, but hey, she’s worked there for 9 years, so maybe she’d have something to input. Nah, of course not, just the script she’s been spoon-fed.

        I’ve had problems with UPS too. I didn’t mean to imply that it was perfect, however, every time there HAS been a mistake, there have been reparations made. Not simply, “oops!”

        Point, again, when you put the government in charge of things, the employees gain a sense of untouchability (That’s not even a word I don’t think, but whatever) and a distinct lack of accountability.

        I have never seen anything as disorganized as the VA hospitals, which incidentally have federally employed health care providers. When I was injured in Iraq in an IED incident, I got better care in-country by the PRIVATE SECTOR CONTRACTORS than the federal employees.

        They could give a shit. They won’t even be reprimanded if you die, let alone have a malpractice suit filed.

        Government getting its paws in health care is a BAD, BAD idea.

        • Jinx says:

          You calling the USPS employee stupid b/c they didn’t answer your question is a prime example of the pot calling the kettle black. You were mailing the package on Thursday, and knowing that it takes 2-3 days for delivery you still ask if the package would arrive by Tuesday.

          Are you not familiar with the days of the week? Well, let’s go over it together.

          Thursday (day 0): You mail the package, but we’ll say it just stays at the post.
          Friday (day 1): Package starts its journey
          Saturday (day 2): Package might arrive, but let’s say it doesn’t :(
          Sunday: doesn’t count as a day b/c USPS is closed
          Monday (day 3): Package should arrive.
          Tuesday (day 4): Why the hell are you asking if it will arrive by this day?

          The clerk answered your question. It’s not her fault that you’re too dense to understand it.

    • J-man says:

      But what happens if you can’t afford the better service? You don’t die or cripple yourself because you can’t pay for postage.

      I have a lot of experience on the recieving end of healthcare here in Canada, and I wouldn’t trade places with any working class American.

      I love your country (and holiday there primarily); I just don’t get why you don’t think healthcare is for everyone. Using that logic you should need to dial in your Visa number to get a firetruck to respond.

      I guess I just don’t get it. Hope I never have to.

    • Chuck in MI says:

      Hi, I happen to live in Grand Rapids, MI and used to use Priority Mail a lot. Priority Mail is NOT a guarentee, however, 90% of packages sent in the continental US arrive in 3 days. If you want a guarentee, use Next Day Mail.

      This is not the USPS being stupid, it’s their policy. Priority is NOT a 3 day guarentee.

      Thank you.

  19. Kris says:

    Who cares if Crackey McCrackhead is doctor shopping? Why waste your time calling around to double check on Crackey? If he wants to doctor shop and be found unresponsive,blue, and foaming at the mouth because he took too many pills or put 2 Fentanyl patches on his butt than WHO CARES and why do you make it your business? Just seems to me you like the stress and drama. My brother was just found by MY 12 year old son not breathing, and foaming from the mouth. He had placed two Fentanyl patches at one time on his body. The way I see it if Crackey wants to remove himself from the human gene pool than why stop him?

    • KELLEY, RPh says:

      Why care about Crackey? In my practice State, pharmacists are required to follow up and report suspected drug seeking behaviors that do not reflect legitimate medical needs…..

      • Alberta71 says:

        would you believe a collegue of mine actually has a huge papertrail, video tape, and a name, address, etc. of a dude who has scammed over 3000 ritalin in her small town, called the cops, they DON’T care, and not only that, they actually said to her “Is this your job…to monitor the public who may be getting drugs and prescriptions illegally?” CAN YOU BELIEVE THAT!!! She is thinking of going to the paper to report her experience. Why do we bother when the cops won’t even take US seriously, even when we have a tonne of evidence???

  20. PharmIntern says:

    You get what you pay for, Drug Monkey.

    You get what you pay for.

    The day the government takes over health care is the day health care in America goes to hell by virtue of the attitudes of Americans.

  21. PhedUpWithPharmacy says:

    This post is exactly why I stopped working in retail and moved to a hospital setting. For the last few months I decided to “help the department” and work 4 hours every other week in the outpatient pharmacy. Those 4 hours were the hardest of the 84 hours I would work int he 2 week period every pay cycle. It always seemed like every time I worked there we had one of the listed problems pop up. No such thing as a smooth day in retail. Ever. No one gets paid enough to deal with that garbage… especially retail techs. $9/hour is a ripoff.

    Take my advice retail techs… go find a hospital and make more money with less stress!

    • 2BAPharmD says:

      God, what state do you live in?

      I work at both a retail independent pharmacy and a hospital ambulatory care pharmacy, and the pay difference is a whopping 95 cents.

      California FTL, although I am happy I’m not being paid in IOUs yet.

      • PhedUpWithPharmacy says:

        Chicago, Illinois. We start hospital techs here around $15/hour. Retail (last I asked) was around $11. I make considerably more than that but I have almost 15 years experience. But the way healthcare is going I agree with you. Pretty soon I expect an IOU in my paycheck envelope.

  22. drh says:

    Hey, man. Sorry so many docs are asses. I like pharmacists. You guys and girls are almost always helpful (every profession has to have some assholes). I love being able to call you and check up on Crackey McCrackhead. I love when you call me about something to check or clarify. I don’t love when you call me that something is a prior auth, but that’s not your fucking fault. I agree–the insurance companies should be blown up. I’ll add them to my terminal cancer hit list.

    Thanks for helping us, thanks for dealing with our mutually annoying patients, and thanks for making me laugh even when, right now, all I want to do is either cry or strangle my Future Ex.

  23. FuturePharmD says:

    I’m starting to think they teach nurses how to completely ignore common sense. We had an amoxicillin suspension called in were the nurse went over the math with the pharmacist and bitched when we adjusted it. She literally called in a dose of 398mg and when told that wasn’t a practical dose she said well it should actually be 398.25mg. Yeah, because that’s better. God forbid we round. And to think, she works in the emergency room.

  24. Wayspirit says:

    I work outpatient in a hospital (restricted retail). The employees of the hospital are REQUIRED to fill theior scrips with us in order to use their benfit plan. They can take them elsewhere, but they will be paying cash. I have been here a little over a year and I have NEVER felt so walked on in my life! They act like I exist only to serve them and wipe their ass after they are done (thank God Vicodin causes constipation…) I worked for a big chain prior to coming here hoping it would improve. I was treated like a fast food employee at the chain store (by both customers and managers). Here I’m treated worse. Apparently forcing employees to come here makes them bitter, and they take it out on me. At least I can return the favor and treat them as they treat me. I don’t have to worry about losing customers! And it’s so damn hard to fill vacant pharmacist positions my job is pretty secure.

  25. Chip says:

    You know, at Drug Monkey’s site not a single one of those comments that disagreed with him would have been published. Yet, he has the nerve to insult everyone who disagrees with him, without acknowledging that he wouldn’t give you the forum to do so on his site. Classy guy, he ain’t.

    • 2BAPharmD says:

      Well, to be fair, he IS a monkey!

    • pharmacyslave2000 says:

      You are absolutely correct Chip. Drug monkey WILL NOT publish any comments that do not agree with his ideology unless he has some response in which he insults the person continuously for not agreeing with him. The fact that he comes to this blog to push his beliefs and insult TAP and his/her readers is beyond rude and dis-respectful. You want to hurl insults like a child, here’s some for you Drug Monkey; you are a pathetic, self-loathing, lonely middle-aged man with no hope of finding happiness beyond your little “blog garden”. I hope you continue to wallow in misery. Have a nice day.

  26. Drug Monkey, Master Of Pharmacy says:

    Chip,

    I certainly do publish people who disagree with me. Just not you. Because what you give me isn’t even worth insulting, with the exception of that National Review article. Which you didn’t write. If it’s that important to you to appear at my place, my only advice would be to keep trying.

    ‘Cause I don’t publish crap my friend.

    • Chip says:

      If what I have to say is ‘crap’ it should be easy enough to refute, or shouldn’t the fact that it is ‘crap’ be self-evident to everyone who reads it? You shouldn’t feel threatened by ‘crap’ at all. But funny enough, you refuse to publish it.

      It makes you feel good when it seems that everyone agrees with you, but it doesn’t make you right. You’re only lying to yourself and your readers by pretending that the only people reading your blog are your sycophants, and you’re not contributing to the debate at all. You’re just an old dude with a shitty haircut, bad attitude, and a drinking problem.

      You’re a crab- you can’t stand the thought of someone that you think is your inferior having more than you, or doing better, so you crane that claw up and yank them back down to the bottom of the bucket with the rest of your miserable compatriots. Surely things will be better when we’re all miserable, right, comrade?

      Regarding the excepted National Review article, the one that you accused to being ‘racist’ for pointing out that minorities tend to have shorter lifespans, which tends to skew the statistics in populations with higher percentages of minorities. It’s easy enough to sling about accusations of racism, especially when you have no intention of publishing the data that corroborates the claims in the article, or even allowing someone else to post a link.

      • Drug Monkey, Master Of Pharmacy says:

        Sigh. Interesting Chip, because I posted a link to that National Review article myself. Everyone go to my site and read it right now.

        I have also sent in comments here, taking TAP to task for something every once in awhile that never got published. You know what I did?

        I realized this was his site, and he could do what he wanted. Why? Because I’m not a whiny little bitch-ass.

        Put on your big-boy pants and get over it Chip.

      • OUT FOR LIFE says:

        You shouldn’t be shocked Chip that Mr. Statist and statist health care advocate would want to silence any dissent. That’s how they work. Their belief systems are all based on faulty logic and feeeeeeeelings, and never contemplate reality. They show one side of the argument because their BS can’t stand up to logical scrutiny.

  27. mepharmd says:

    you miserable retailers should give it up and come to hospital, we get to sit on our fat asses all day, get 1/2 hour, 45 min for lunch, no customers to get in our faces, no insurance company crap to deal with…..it is such a better world………best kept secret in pharmacy, imho

    • Watson349 says:

      I’m assuming you’re talking about in-patient pharmacy. May I say: “where’s my missing med?” “it’s not in the pyxis” “I don’t have time to get you the ht/wt, you need that for Heparin drip?” These ARE RN’s by the way

      • mepharmd says:

        yes, inpt, I would rather deal with RN’s than the customer service in retail, I’ve done both and find RN’s much easier to deal with overall and not having to deal with idiotic insurance companies makes it such a relief!

    • PharmIntern says:

      Staff pharmacists at hospitals earn (rather significantly) less $$$ than they earn in retail. I’d like to pay my student loans off as quickly as possible, so I’d rather do retail while I’m young and can handle the stress (and am willing!).

      My hospital rotation was just like you described, though; *significantly* less stressful than retail.

  28. RphSlave says:

    All Ive seen in the past 10 years is how people have got more hateful than ever. Your pharmacy is McDonalds….get it done in 2 min or less. But what? What if your dr wrote something that will kill you? What if you are allergic? What if some dumbfuck assistant at the office who cant pronounce any of the drugs and is such a lazyfuck in that they just say fill them as before. Yeah, Im suppose to know what their current med list is. Only to find out when they get home they bitch at me for filling something they are not on anymore.

    Hey…you also forgot about fighting with Upper Management: wanting waitimes to be higher, make people happy, keeping payroll under, doing the job of 10 people because you are short. And if you say anything it only falls on deaf, dumb ears because uppermangement are not pharmacists but only those who are willing to suck someone’s cock and be their Bitch to get the job in the first place.

    DUDE YOU ARE MY HERO!! :)

  29. RphSlave says:

    Why care about McCrackey….because believe it or not we took an oath and I wont throw my ethics out the door. I dont fill for Dr. Shoppers. I lie the instant if they ask if I have Watson, or what color/shape pills I have. And if they really PISS me off: I will write too early on their rx’s. NOT in the corner though…they tear that off. Nope I write it in the middle of the script in RED INK where it CANT be missed. Makes MY day when I burst thier bubble.

    If there can be 1 good thing about MJ’s death: where or where is that drug database so that no matter where anyone goes, cash or insurnace…we know what controls they are getting filled.

    And something I would love: if they are sitting on their fat asses collecting a check from MY tax dollars…once found shopping they should change the law and revoke thier card and prevent them from signing up for a card in any other state again.

    Or I could continue to help the drug problem and encourage the dr’s who have waived flushed their ethics down the toilet and allow my tax dollars to fund their rehab only for them to abuse that system as well!!

    • Kris says:

      Oh I think the things you do are great! I wish someone would of done that for my brother. He had a doctor giving him 120 10 mg Percocet every 2 weeks. If a pharmacist did what you did that maybe would of been helpful. Although I doubt it. Crackey is going to do what he wants to do. If you couldn’t tell about my first post I am so pissed off at him I could of kicked him in the head when my SON found him. Selfish POS as far as I am concerned.
      I just don’t see why you would spend 2 hours on a phone investigating a patient. It seems like a waste to me.

  30. Well AP, i don’t know how to follow these acts. They said it all for me. I left retail in 1993, and am not only grateful for that decision, but also grateful that I did not have to endure painful factors on the list of woes that has been added to your environment since I left it. It was a fight then, and more of a fight now. If I were to return to it, I would have to buck up on my ability to accept the presence of misery. I have a classmate who told me simply, “I let it all roll off my back. I don’t let it bother me.” Must be a spiritual act on his part. I’d have to do the same thing.

  31. ChemoQueenRPh says:

    MePharmD,
    You must be one of those lazy old fucks that work in my hospital system. Must of us bust our ASSES because we actually CARE about patients and try to meet their needs in a timely manner. We take shit from nurses when we try to clarify obviously wrong orders. Thank GAWD we can clarify the fucked up home med lists they write because nobody can copy shit off the prescription vials patient’s bring in. The smart nurses just call us to straighten out the mess so we can figure out what the heck the patient is supposed to be on. With the help of our retail bretheren of course.
    You lazy fucks just leave that shit for someone else. We don’t take a lunch or a break so we can work 8 hrs & just go home. You must not get calls for a stat from ER, then before you can start on it, you get a atat call from NICU, then before you can start on that, nurse fucky McFuckhead calls bitching that she sent that order HOURS ago and it STILL hasn’t been sent up yet. The tube system (if you have one) jams. The fax jams. Your techs won’t answer the phone that rings and rings. And you have to chase them out the door with a whip to get them to take a run out that should have gone out 30 min ago. And now you are getting shitty phone calls about that, cuz THEY aren’t the ones who take the shitty calls.
    No disrespect to those awesome techs and pharmacists who don’t represent the above. Just pointing out that hospital has it’s share of fighting all day long as well. The only hospital pharmacists I know that don’t get stressed about it are lazy fucks.

    • mepharmd says:

      “The only hospital pharmacists I know that don’t get stressed about it are lazy fucks.”

      or the ones who used to teach in the public school systems, nothing at the hospital that I am fortunate to work in (relatively small and rural) compares to the stress of that. And I do know very well the kinds of pharmacists, techs and nurses (and equipment failures) you describe, but that is the minority and I just don’t dwell on it, I rather focus on those awesome techs and nurses. And I am not the only hard working, ass busting, often found in the trenches with the techs kind of pharmacist that you and I are, I am fortunate to work with several others like ourselves….perhaps you need to find a new royal court to assist you my queen.

  32. DrBobbs says:

    Well said! Most of this describes the practice of medicine as well.

  33. S.N. says:

    I have not seen you this negative. I said I’d quit reading. I really will now. For 100k a year. no one’s kissing your butt. Your job’s hard. So is every other health professional’s. I know this is what’s in store for me, at least.

    • PharmIntern says:

      Who said we don’t know this? This site is tantamount to coming home after s long, hard day’s work and griping to your wife/husband over dinner about your job. It happens to everyone with everyone’s job, and if you don’t let it out now and then, you’re that much more likely to perch yourself on top of the clock tower with your Winchester and start picking people off one of these days.

  34. phried says:

    just another day in paradise…..i also suffer the same fools and foolishness on a daily basis, but i’m just a gov’t whore based on
    where the majority of the reimbursement/payments come from….
    kills me to see our tax dollars wasted the way they are….

    just sooooo thankful i’m in the ‘twilight’ of my career, i have many
    good patients but things are so different than when i started over
    2 decades ago….yeah i’m an old phart….but i too write all over
    McCrackey’s rx, get reported to DM, on and on….i just don’t care
    any more EXCEPT for my ‘good’ patients and i am capable of this
    ‘judgment’ after all the years….i now have more phun screwing with
    the problems as i don’t care….fire me if you wish….but alas,
    no one has yet………

    still love your site!!!!

  35. HRH ChemoQueenRPh says:

    “I am fortunate to work with several others like ourselves….perhaps you need to find a new royal court to assist you my queen”

    I HAVE found a new Royal court LOL
    I am very lucky to now work in an Oncology Infusion Clinic with another ChemoQueenRPh, ass busting techs, great nurses, and our Docs value our input. Most of us have been there for the last 3-5 yrs, so we are a tight knit group. I get to do all kinds of stuff I would never get to do on the inpatient side. Make no mistake, we certainly have our share of chaos that leaves me fried crispy. But, alas, that is healthcare.
    Sorry, your original post brought back horrible flashbacks of those lazy old turds that would take ONE page off the fax machine at a time, when it was spitting out orders like a tsunami.

  36. mamab says:

    I just gave up the good fight. 32 years–hospital-long term and retail–and the retail sucked all the compassion and care out of me. I could not bring my kids to “take your children to work” days because I would not want them to see me treated the way I am–couldn’t let them hear the language that is used–didn’t want them to see someone irate about their
    $1.10 copay throw their recept at me and tell me to wipe my ass with it.
    Looked up from what I was working on a few months back to a gun in my face and “give me oxycontin” same thing the next month but a more aggressive and confident robber. I am done.

  37. Love it says:

    Really love this stuff. Yes it is always fighting. Trying to create a site of quick stories for everyone to share their stories. Dumbmedicine.com is the name.

  38. OUT FOR LIFE says:

    Sorry, I forgot about the Universities. Perhaps this isn’t the best place to make a stand, since, in fact, it is now commonplace to have public funding for Universities so McGill and U of M are both publicly funded as are the vast majorities of Universities in the world. However, it is interesting to note that the number 1 and number 2 universities from the study you site have on thing in common: they are both private. So in a field in terms of shear numbers where public universities are overwhelming it is remarkable that the most elite are private. Amazing how that happens.

  39. lsvtec_ekgrl says:

    I love this guy! Wish he was my boss!! The day would go by so fast haha!! I can’t wait to get out of Pharm school…I’m going to apply at his job!

  40. YoungAngryPharmD says:

    I love reading posts in this forum. Although I do my best to not take anything personal at work, it is nice to know that I am not the only one who goes through this same bullshit day in-day out. Lately I have been thinking about moving back home to practice pharmacy in the midwest (because Tampa is full of botarded white trash), but I know it will be the same shit from customers in a more “sophisticated” and educated manner.

    Angry Pharmacist- I appreciate you posting this. If I could meet you in person or practice with you for a day I would be humbled. With your permission, I would love to chime in and post in your forums. Keep up the good work pharmacists, and for the rest of you, go eat some Iraqi camel shit.

  41. sandee says:

    Drug monkey is one of those people that stomp their feet and cry when they do not get their way. You would think he would grow up at some point and realize that everyone is entitled to their own opinion and that there will never be a time when everyone will all agree on the same idea!
    He needs to grow up! Age wise I would put him at around five if that. After all the knowledge he is supposed to have one would think this would be the first thing learned. Everyone has different ideas and are completely entitled to their ideas! Just because stomp your feet does not mean they will magically change their views to yours!

  42. Anonymous says:

    I work for Wellpoint. Evil. Corporation.

    “At the end of the day, when you sit down for the first time in 9 hours, you realize that it all is just going to repeat the next day.”

    This is the truth. I sit and wait for Wellpoint provider calls during an 8 + hour period. All I do is fight bullshit and ignorance both on the corporate and provider spectrum ends only to have a moment’s breath of rest and having to return to it the very next day.

    God help us all. Health care in this country is a tradegy, claiming its victims each year. Less provider reimbursement, no patient advocacy and bigger management and exec salaries. It is breathakingly digusting.

  43. Jen says:

    I’m a pharmacy tech and I feel like I could’ve written this post. It’s so funny yet so so true.

  44. Katrina CPhT says:

    My favorite is the ER prescription pad that’s used by 4 different ER facilities, in 4 different cities around the area yet the doctor doesn’t bother to check which ER he’s from,his name isn’t printed on the prescription anywhere and he just scribbles his first and last initial, pt’s friend is dropping of the prescription because the pt is at home in pain, has no idea which hospital the pt was seen at or which doctor was seen, and you have to clarify a strength, so You have to call all 4 ER’s to wait on hold with each ER while the “know it all” receptionist transfer’s you to every floor in the building in search of your pt, just to find out the doctor left for the day.

    Or another one….. Need to change the drug. Call the doctor’s office…

    Receptionist ” I don’t know that doctor”

    “Ok well his name is typed into this prescription that has your phone number on it. Let me give you the spelling”

    “Nope that doctor doesn’t work here”

    “Ok then how do I have a prescription from your facility with his name on it? Let me give you the pt’s name maybe you can look it up that way.”

    “Ok yeah… the pt was here today.”

    “Alright…. and which doctor did the pt see?”

    “I don’t know.”

    “Ok…. is there anyone there at your facility who would be able to find that out for me? I need to speak to someone about changing a drug, written by the doctor”

    She transfer’s me

    “Hi this is John, at blah blah blah hospital pharmacy”

    SHE TRANSFERRED ME TO THE FREAKING HOSPITAL PHARMACY!!!

  45. Farmacyst says:

    I hate the bitchy patients when it comes to over the counter sales of codeine based preparations, total junkies.

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