The dreaded RTS

What is the public enemy number 1 of any pharmacy?  No, its not the patients.

Its the dreaded RTS bin.

Thats right! The Return To Stock bin.  The glorious bin of drugs that patients called in to have refilled “RIGHT NOW” yet never got off their lazy asses to come and pick up.  You know, all the simvastatin and lisinopril that the patient pitched an absolute fit right in the store because they “were out” and didn’t have any refills remaining yet never bothered to pick up 2 weeks later.

RTS’s absolutely kill pharmacies.  Here’s why (to those at home who don’t work in a pharmacy).

It takes money to fill a prescription (gasp!) other than the raw cost of the drug.  Everything from the vial, to the label, to the computer system/printer/toner that spits out the label (that you fucking don’t read) to the tech that fills it, to the pharmacist that checks it, to the clerk that puts it in a little bag and takes your whiny phone calls.  All of those steps cost money.  Thats not even counting the electricity, insurance, employee taxes, etc.

We get a dispensing fee paid for by YOUR insurance to cover these fixed costs.  Why are they fixed? Because the dispensing cost is the same if the drug costs $1 to $5000 kerzillion dollars.  When you pick up and sign for the medication, we have proof to your insurance company that you in fact received the medication and their piddly $2 dispensing fee was in fact put to its intended use.

Now say that drug filled vial with your name on it just sits out front for a few weeks.  It starts to get lonely sitting by itself in the pharmacy because contrary to what you read on the internet, just ordering your medication doesn’t make it magically work, you need to TAKE the fucking medication.  Eventually, we need that space to store medications for people who give a fuck about their health.  Your vial then gets RTS’d.  Since we didn’t dispense that medication, we legally cannot accept the money that your insurance company paid us for the drug + dispensing fee.  So now, we “back out” the prescription (meaning we give the money your insurance company paid us BACK to them, all of it), and now must PAY someone to put the drug back into the big stock bottles.  We have to throw away the vial and the label as well.

Your laziness now has cost the pharmacy double the labor + the cost of the vial/label  for which we are getting paid a whopping $0.00 for.  All because you called in a refill and didn’t get off your ass to pick it up.  My store has a policy that we call people once their medications have sat for a week, then we give them a second call 5 days later.  Yes, we PAY someone to call you to remind you that the prescriptions that YOU CALLED IN have sat here for a week.  This is after we told you when you called in your refills that they will be ready later on that day.   Ask me how this can be any more straightforward!  Oh, I guess its as straightforward as paying your fucking phone bill because every time you come in you give us ANOTHER phone number (thats disconnected 2 days later).

After about the second time I RTS a prescription for a patient, I put a big note in their profile to make sure they are told that we will fill their prescriptions when they are IN the store due to us always putting back into stock what they order.  What do I get? A bunch of swearing at me from over the counter by some idiot unwashed mouth-breather to the tune of “I called these in a week ago, why aren’t they ready yet!”  This is after they were EXPLAINED why they must be here for me to fill their “diabeetus and list-o-pril” pills.  I swear I can’t fucking win.

This shit really pisses me off.  Its a waste of my fucking time and a waste of the stores money.  Since my store doesn’t do auto-fills, if you’re not going to take your fucking medication, then save us all the headache and don’t call it in.

Oh, and a cool pharmacy fun-fact, is that controlled prescriptions are a good chunk of what I fill everyday, yet less than 1% of the drugs I RTS.  Big fucking surprise.

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115 Comments

  1. Colorado Pharmacist says:

    This must be a bigger deal at non-chain pharmacies. Our system sends the reminder calls, and half the rts are our auto-fills anyway. Realistically the company would rather get the drug ready under the chance it gets picked up then to not have filled it at all. The cost of ink, paper, and vial isn’t much. You were going to pay all the other fixed costs if you filled one more vial or didn’t.

    If rts is really this big of a problem at your pharmacy then you aren’t harassing your customers properly. The chains know that you can have the automated system call them daily until they pick it up.

    • Independant pharmacies don’t have the backing of stockholders, corporate offices, nor do we enjoy harassing random people with a phone-number that no longer belongs to the patient ;)

      • OldRPHBs says:

        I swear if I was just a regular customer and got as many calls from my chain pharmacy as we have to make, along with the automated calls. I would go to another pharmacy. Harassment indeed.

        • PharmIntern says:

          I’ve had people, not bullshitting you, tell me our computer called their house 5 ( yes, FIVE ) times in one day. Not one person, mind you. PEOPLE told me this, as in, like, three or four people.

          Harassment indeed!!! I don’t know how the put up with it.

        • BandAid4RiteAid says:

          You have to be taking about CVS.

    • Brad says:

      Wait until the FCC approves Express Scripts purchase of Medco. Then the dispensing fee will go to -$2 and we will be charged to bill a patients insurance. You KNOW they will find a way to do that. Heaven help us.

    • Huh??? says:

      You poor thing.
      God forbid you fill a script
      Its a shame that you have to pay you slave wages a $7.00 an
      hour and then one of your peons actually makes a call.
      As well as having the lights and the heat on you could always turn them off why have a building you could dispense the stuff from the back of you car. You are lucky to have a job. Having to deal with those mouth breathers how about we the poor customers that have to deal with the now arrogant pharmacists who now want to be the doctors wouldn’t that be nice for you the pharmacists being the doctors I bet you would like that. How about come back in an hour to pick up your medicine it takes that long 1,2,3,4,5,6, oh shit where was I 1,2,3,4,5,6 just count the pills already. Imagine that expensive label and toner going to waste. we all have wasted enough time with a pharmacist whose only major concern is stopping some “drug ring” god forbid you have some controlled substance you are immediately up to no good. Just count the pills and move along.

      • so tired of this says:

        Obviously you do not work with the public, or the drug-seeking public, the lying, drug-seeking public who would sell their grandmother for a xanbar. Yes, I have seen much in my 25 + years as a pharmacist. No, I do not want to be a doctor. I’m sorry if I am well compensated, but I can be sued for an error that doesn’t cause harm. If you did not go to college or earn a living wage, DON’T BLAME ME!!! No one handed me anything.

  2. jacob hyatt says:

    You forgot the part where they show up 3 days after you returned all 14 of their free prescriptions and insist upon waiting for them only to walk down the street and transfer all 14 after you filled them for the second time.

    • Crusty RPh says:

      If I fill it, I will not transfer that filling and I refuse to get transfers from other pharmacies that have already filled RXs without a real good reason. We all need to stick together on this one. There no reason to become the public’s bitch on this subject. I will transfer the RX for the next filling without a problem – but not one I have already filled. If I get a call from the insurance company – I tell them it will take 5 working days to process the RTS. Fuck them all.

  3. Jimrx says:

    I hear you, AP. Especially the meds that have zero copay. All the patient has to do is just pick it up. But noooooo….Deal or No Deal is on. Ingrates.

  4. Kevin says:

    Our computer system sends automated reminder calls once the rx has been checked, and then every 2 or 3 days til you pick the damned rx up. And we still have customers that will tell us “Well nobody ever told me it was ready!” Except that we’ve called you 5 times to let you know it’s been sitting here. While I’m filling in the morning I check any rx that has “auto-fill” in the comment field to see how many times it’s been RTS (because once it goes back into stock if it’s on auto-fill, the computer immediately redrops it to be refilled) and if it’s been returned 2 or more times it’s coming off auto-fill. Call me a bastard but I’m not refilling your rx 3 times for you to not pick it up.

  5. Dr. Grumpy says:

    Yeah, drives my staff nuts, too, when these bozos change cell phones every few weeks so we can’t find them to do a reminder call about an appointment. And then, of course, they pitch a hissy fit because they missed their appointment and now I won’t refill their pills.

  6. radrone 5316 says:

    Colorodo Pharmacist is a dullard, exactly why I can’t stand socializing with my fellow pharmacists. I would hang out with you “angry pharmacist” in a minute though ! Betcha I’m angrier than you are, but damn you make me laugh.
    PS: everyone else….who cares how your store or computer system “does it” get the poles out of your ass.

  7. Jack says:

    RTS-ing isnt a problem where I work, (<10 per month) but what happens of you just DONT reverse the claim, keep the dispensing fee AND the cost of the med?

    Fuck the stupid, shitty insurance companies and their insult of a dispensing fee!

    • GregMo says:

      What happens if you don’t reverse the claim is you eventually get audit and fined out of business for insurance fraud. Big insurance companies have tons of lawyers that are just waiting for the phone call to go ruin someone’s life that does exactly what you’re suggesting.

  8. DaftTech says:

    What really kills me is when it’s not just 30-day vial Rx’s, but compliance packaged ones that took 3 times as long to prepare and 3 times as long to RTS.

  9. PharmIntern says:

    The biggest culprit of RTS for my company is the auto-fill system; I swear, at least 1/3 of the auto-fill scripts filled get RTSed. That said, it makes me wonder how the people are split the way they are: about half love the auto-fill system, and the other half can’t stand it. Like many above me have said, if I got called by my pharmacy as much as the pharmacy and the computer system calls these people, I’d find another pharmacy that doesn’t bother people at home so much.

    How much is too much in terms of babying people along with their healthcare? People should take control of their health without us having to call them multiple times a day to remind them that X prescription is ready to go, prescriptions Z, Y, and Q are due to be filled, and prescription W is past due to be filled, “we were just wondering, are you still taking these medications?”.

    The RTS list every day really does piss me off. Such a waste of time, money, resources, and effort. Thank you, auto-fill, for causing us more work that costs the pharmacy more money. Sure, more people are filling scripts ( by default, if on auto-fill ), but do you think it actually helps improve adherence? “You can lead the horse to water, but you can’t make it drink.”

    • DeanRx says:

      You and I both know its NOT about increasing adherence. Its about a feable attempt to increase SALES. As a big corporate pharmacy big-wig (if I was one), I couldn’t give two hoots about the patient’s health, but I sure give a damn about sales. So, if I figure I’m already paying you and the staff to be there, I might as well get as much work out of you as possible.

      And don’t worry. All the extra non-patient care bullshit hoops I make you jump through mean nothing when an error is made and the QA committee reviews it and recommends disciplinary action against the “offending parties”.

      Its just another sales driver, much like those coupons for transfers that you like so much. Its not that the corp. types don’t KNOW it slows down the providing of care – they just don’t CARE that is does, because they still get to hold the pee-ons to an unattianeable time standard that none of themselves could meet. That is, if they ever chose to take a day out of the corporate office, e-mail / meeting, solve the worlds problems, TQM world and actually step in the trenches to fill a script.

  10. niterph-pacingmyselfsargeant says:

    Auto-Fill is probably the biggest culprit to this RTS fiasco. IMHO auto-fill should be eliminated, as it could potentially cause more harm than good. Since we all know that patients don’t know shit about their medications, and see so many different doctors, how the hell do I know what their current up to the week therapy is for every one of their damn disease states? Is the doctor adding a drug to their therapy that they’ve been on for 6 months, or is he replacing it? You could ask the patient, but WTF do they know. Clusterfuck doesn’t even begin to describe this shitty profession. Youngsters, run away as fast as you possibly can. Oldsters – drink daily.

    • bcmigal says:

      I do not know about anyone else’s Auto-fill, but our program does not allow pts to schedule a certain fill day. (I tell them that they have auto fill confused with online banking!). Today a pt returned meds that had been autofilled twice because she neglected to tell us that her MD had changed her therapy. So not only did we waste our time filling them, but now the TP will take back the payment. You are right, we should charge a restocking fee!

  11. Roblol says:

    I have a similar issue in an unrelated field. I provide premium support for customer’s paying a subscription fee to their ISP. We remove viruses, do pc tune ups, and any kind of software support they need; basically we fix their pc after they browse porn with 1 hand.
    The customer service departments sell them “anti virus” and somehow the customers get it in their thick heads it just works without being installed.
    I run into such retarded people so often I have to now blog about it to release the stress. It’s upsetting to know people are as irresponsible with professionally prescribed medication as they are their computers. Especially considering you can’t just start over quite like on a PC.

  12. ODP says:

    Don’t forget about the patient on Provigil ($1500 per bottle) that calls in for the refill then decides to transfer the script to another store for a gift card. Not only do you have to RTS it, now you have an opened stock bottle of a $1500 med (that no other patients are taking) that you can’t return to your supplier.

    • pharmdude says:

      One rule–NEVER and I mean NEVER–open and expensive medication until the person is right their in front of you and pays for it.

    • Mark says:

      Whenever we order an expensive med, we leave it in the original unopened bottle until the pt actually shows up and purchases it.

    • Angry Baseball Bat Swinging RPh says:

      ….that the insurance would have only paid 1295 dollars plus a 2 dollar dispensing fee for. In some of these cases you’re “making” more money handing the patient a competitor’s gift card and sending them down the road, than you are actually dispensing the med. And when I say “making” more money, I mean loosing less money.

  13. bcmigal says:

    You are soooo right, TAP. In our chain, our labor is budgeted not on rxs filled, but on rxs actually picked up! So all the work done to fill an RX (esp calling the MD, calling the third party, faxing for a PA, and personally calling the pt 3 times) is time and money that you will never get back. The only valid comment by “Colorado Pharmacist” is that we also get to spend our time and the company’s money harassing the patient. We are “graded” on how many times we call and whether or not the pt picks up the meds. RTSs are a very big deal. And , Jack, if the pt does not pick up and you keep the money, that is insurance fraud. Companies have been fined millions for that. You may not care but your mortgage company may when you are out of a job.

    BTW, my fav customer comments this week are: “No one told me there was no refill” and “No one told me the prescription had expired. You should have told me that when I picked it up.”
    Should we take the medication for you, too?

  14. I have to to with the commenters on AutoFill. WHAT A crock of crap. We fill..we return…we fill we return. I have had enough people on auto fill refuse to pick of their scripts after 2 calls that I finally took them off autofill without telling them. Most hardly notice, but I had one lady argue with me. “but I want auto fill”. I told her ” Sorry Elizabeth, I returned your scripts one too many times. You are either non compliant with your medications or unable to get to the pharmacy, and I am not going to return 13 (yes 13) rxs every month because YOU SAY YOU ARENT OUT..”.

  15. mark says:

    I had the same thing happen today, I transfered a script for 30 Provigil, after we already filled it

    • Crusty RPh says:

      Fuck em – transfer the next filling. You have already lost the customer, you might as well get your cost out of this rx. If they bitch – explain the situation – if they continue to bitch – go back to fuck-em

  16. I’ve always thought that pharmacies should be entitled to a fee for RTS prescriptions. Similar to the dispensing fee but you could call it a restocking fee or give it whatever name you wanted but the idea would be to get something for your labor and time. After all, you fulfilled your obligation to the insurance company by preparing the prescription for a patient. It isn’t the pharmacy’s fault the patient didn’t pick up their medication. Restocking fees are commonplace in other industries so why can’t pharmacies implement this same idea even if it is for a token amount like $1. It only seems fair. But then again fairness flew out the window years ago when you are talking about pharmacies and insurance companies.

    • Crusty RPh says:

      Absolutely correct – the fee should be the existing dispensing fee for the rx. Unfortunately, most of our rts rxs are cash.

    • radrone 5316 says:

      Yeah Right, like that’ll ever happen. You tell the insurance company it’ll cost them 1 dollar if their covered patient doesn’t pick up their script, and they’ll say FUCK YOU, we’ll mail it to them from our Giganto Mail Order Pharmacy directly, or just deal with your competitors who won’t charge us (certainly not in any type of anti-trust way). And counseling, we have a DOCTOR (PharmD) on hot-line standby, ready to answer all their questions ( average wait time today is 45 minutes)

  17. BandAid4RiteAid says:

    All I can say is this: As a pharmacist myself I have NEVER met such a bunch of pussies in all my life. And I say this with sadness and deep regret, but it is true.
    This may be unrelated to the current topic, but I have never seen such a collective group of spineless-let-me-get-rolled-over-and-done-dry people in all my life. This profession is going down the shitter and you are worrying about a RTS situation? Wake the hell up because this is the least of your worries.
    If the medical profession is a blue dress then we are the stain on that dress Monica didn’t wash off to fry Bill Clinton. Doctors get paid to e-script, we pay to accept it. Doctors don’t write the date on a prescription, the insurance takes back ALL cost and reimbursement if we don’t do it, even though we have no idea when it was written. Don’t punish the physician, fuck us over for his laziness.
    Bottom line: We get screwed by insurance companies with the help of physicians, yelled at by patients, and poked and prodded by corporate and you are worried about RTS items??? Give me a break.
    Some of you asshole pharmacists voluteered to give vaccinations, then bitched because your partner didn’t because it wasn’t fair. Because of your stupidity for volunteering you push to drag others down the rathole with you. Misery loves company I guess.
    To all you corporate ass kissers out there – and you know who you are – I say Fuck You. Screw you for being idle while this profession goes down the shitter. The only time a majority of you pharmacists show any kind of urgency is when your thrusting your face up your DM’s ass.
    Guess what? The pharmacy shortage is over. You have all these new grads with massive student loan debt that will be more than happy to take your job for $30,000.00 less than what they are paying you now. So keep on your knees and ramming it down your throat. It may buy you some time, but The Man will get you too, eventually.
    I guess we’ll all go down together.
    Spineless pussies.

    • radrone 5316 says:

      That was GREAT BandAid4RiteAid. As a RA drone myself I think I am the sole hold out on the certified immunizer bullshit in my entire district. These pharmacists have always been wusses, they take their checks and abuse and feel content in their boring lives. Don’t get yourself aggrevated, the abundance of younger and foreign grads coming into our job market for less money is already written in stone. BTW did they tell you that it is a “job requirement to be a certified immunizing pharmacist” , cause they tell me that once a week.

    • sumotoad says:

      The owners have one concern and that is to get the job done as cheaply as possible. Those of you PharmD’s who think your job is safe are wrong. Your 30 years with Walgreens wont mean shit when Aboo from pakistan who can’t speak English and doesn’t know the difference between Xenical and Xeloda shows himself willing to do the job for $30K less a year. Tell me a year from now that I’m wrong.

    • Rph 1984 says:

      We didn’t band together in the 1980′s, while WE had the upper hand.

      I’m afraid it’s too late now, in my state (Washington) new hires in “retail” have already gone to work for lower wages (25% less) than what I made earlier this year. For those of you who think you’re “safe” (especially if you’re over 50), “wake up and smell the coffee”.

    • pharnacyphil says:

      I could not agree with you more, BandAid4RiteAid. Pharmacist are the biggest bunch of spineless, manipulated, kiss ass (not lazy) FOOLS on the face of the earth. We have no will to stand up for our profession. We bow down to corporate, state and federal manipulation at the expense of our career satisfaction and enjoyment. Today, as a 30 year career Pharmacist, I am ashamed at the bullshit that I swallow day after day. Having the feeling of helplessness, as Corporate loads more and more useless crap into our workday- WHAT THE FUCK!! Pharmacist advisor, readyfill, first fill counceling, PCI calls, immnunization push, ready in 15 min or less, answer the call in 20 seconds, drive thru satisfaction, Triple S., Workload manager, Foolish state regulations, Foolish federal regulations. I won’t even get into customer complaint issues, crackhead druggies etc.

      IF I NEW 30 YEARS AGO WHAT I WOULD BE FACED WITH TODAY, I NEVER WOULD HAVE PERSUED PHARMACY/
      What a waste of a career…………..

  18. chelsea says:

    WOW! a collection of the most vile and unprofessional pharmasits ever! LMAO Its the shitheads like you guys that make me sick. If you HATE your jobs(and the people you serve) so much then find a new fucking job idiots and stop your BITCHING! my god you are so stupid sitting here ranting about the little costs of filling peoples meds. lemme tell you something… NO ONE CARES ABOUT HOW YOU FEEL. YOU ARE PAID TO DEAL WITH WHATEVER THIS PROFESSION THROWS AT YOU. GET A FUCKING LIFE LOSERS!

    • Crusty RPh says:

      YOU CAN’T BE A PHARMACIST.

    • radrone 5316 says:

      we are unprofessional “pharmasits” cause we are all PHARMACISTS. You must be some loser store Manager who is brainwashed by your DM and corporate. Your important job, cleaning the bathrooms, bossing around teenagers, unloading the truck at 4am, and making the PHARMACIST’s work day miserable must really be worth it, or were there just no openings at Taco Bell?

    • Rph 1984 says:

      Chelsea,
      You sound VERY much like the classic “jealous tech”, someone who wants the money a college education brings, but is UNWILLING to undertake the WORK, or the debt, it requires.
      Why don’t you just go to Pharmacy School yourself, like six(6) (or maybe more, by now) of the techs I’ve worked with.(If you can’t beat em, join em.)

      It doesn’t matter if you’re “not smart”, just go to one of the “new” schools that will accept anyone with a 2.0, who’s willing to pay their “massive” tuition, California has a “boatload” of these.

      • smartTech says:

        Not all tech are jealous, I have endless opportunities at my independant pharmacy. I was actually going to go to Pharmacy School but had a stroke at 25 years old (at the Pharmacy) and obviously that was difficult. But I still feel very fullfilled working side by side and in some ways leading in our pharmacy. I am extreamly well paid and trained. Opportunites and jobs are what you make of them. Other pharmacies and pharmacist are constantly seeking my knowledge of long term care, drug returns/disposals, medicare billing….you just have you find your niche.

    • BandAid4RiteAid says:

      Chelsea, unstrap that mattress from your back and remove your kneepads you wooley cunt! Just because your profession is the oldest known to man doesn’t mean you can make comments on this site between tricks you piece of shit. One more comment from you and I am going to call your pimp, Tyrone Washington. He will will make you have sex with that well-hung midget with the lazy eye again.

    • Disgusted Pharmacist says:

      No–You are the ass-wipe! If you haven’t done this job—DON’T read this site. Not only are you NOT a pharmacist–I’m sure you don’t daily deal with people are you’d shut the fuck up!

  19. Happy Non-Pharmacist says:

    I bet you never have to RTS any narcotics.

  20. niterph-pacingmyselfsargeant says:

    I forgot to mention that everything related to pharmacy makes me angry.

  21. Cody says:

    Wonder if it’ll ever come to pass where insurances DO pay pharmacies regardless of whether the patient came in or not, and if we have to RTS, the insurance bills a fee to the patient. It can even be $2 per RX, same as we get paid in the first place by the insurances. That right there is incentive for the patient to buy their medications directly after they’re filled.

    ….Nah, who am I kidding?

    • Crusty RPh says:

      That is the big advantage of Mail Order – The patient’s credit card is billed immediately – Called in a wrong number – too bad. Medication discontinued – too bad. You hang up and you are billed.

  22. Cracky McCrackhead says:

    You will never see any my scrips go RTS. I always pick them up!

  23. Marky B says:

    Then there is the old lady that calls and says “Fill all of my subscriptions!”
    The tech dutifully fills all 18 of them.
    She comes in and tears open the bag, empties it onto the counter, and picks out two bottles ( you can guess what they are).
    “I don’t need those other ones right now.” Then she tells the person behind her how bad we suck and how we are trying to cheat her out of her money with our high prices.

    • kdog909 says:

      I let customers try the “fill all my meds” shit once. If everything goes OK, then I let them do it every month. But if they pull the “Why didn’t you fill the triamcinolone cream I got 8 months ago?” or “Why did you fill my atenolol I’ve been on for 10 years, the Dr. just took me off that!”, then I put a note in their profile stating that they must specifically state each medication they need, no matter how much they bitch and moan about it.

      • Linda says:

        I am a tech and this one of my biggest pet peeves! Unfortuneatly the Pharmacists I work with tell me to “figure it out”. What I want to say to the lame patient is “call me back when you acutually get a brain”. If the patient does’nt know what the name of the meds they are taking they should be in assited living! This is one of the reasons that I’m looking for a non-retail tech position.

    • smartTech says:

      Huge pet peeve. I absolutely will not have this. Tell me what you need or I am not filling it. How am I supposed to guess out 4000 rx what you need? If I have to I will read them off.

  24. kattie says:

    I’m not sure but I don’t think my pharmacist talks like ‘this’. I’ve known him, and other pharmacists in the pharmacy, for over 10 years and he is very helpful and he has had some pretty rough rounds helping me out by what he has had to deal with on doctors and insurance companies. Questions: Do you ‘really’ have that many people that don’t pick up their med? My problem is between the meds that have to be ‘reapproved’, ‘can’t be auto-reordered’, ‘doctor forgot to fax in’ or ‘faxed to wrong pharmacy’ my blood pressure goes so high that I feel like giving up. If it were not for my pharmacist, I would have just quit taking the BP drugs by now, plus cancelled my insurance.

    Do you guys/gals really had your job. Need honest answer. I have a grandson in college that is going into ‘Pharmacy’ this Fall. Please tell me these are NOT your true feelings.
    Kattie

    • bcmigal says:

      Tell him to find another field. He will owe more on his student loans than he will on house. Jobs will be scarce. Working for the corporations is disheartening and demoralizing to put it politely. Unless he goes into research or uses his degree as a stepping stone to another career, he will be unhappy. The real world is nothing like pharmacy school.

    • Crusty RPh says:

      Don’t get us wrong – 95% of our patients are like you. We will go to the mat for patients that need our help. It is the other 5% of the patients and insurance companies who waste our time – which takes away time we need to spent with patients who need our help.

    • sumotoad says:

      Tell your grandon that it is more psychologically rewarding to blow bulldogs in a donkey show in Juarez than to do what pharmacists. We really do hate our job. Our profession is great. The job sucks. Insurance, the government, and the customers make the job suck.

    • got the oc's? says:

      Pharmacy sucks-the short list- no support from corporate, long hours & holidays, still no lunch breaks during 12-14 hr shifts @ 2 largest chains, crackheads pestering you all day long. Tell him to pick another field.

  25. Jon Lindau says:

    I hate return to stocks, especially C2s. We should start keeping patient’s credit cards on file (securely of course) and charge them 50 cents for every script they fail to pick up!

  26. The angry consumer. says:

    Well I uncovered a sweet (for the phamacy) apparently legal scam here in Florida. I found the local pharmacy refilling my Mom prescriptions (she is in a nursing home) in 31 day increments so they could charge her TWO co-pays for each month’s supply of medicine. I was able to get her refills adjusted to 30 days but wonder how many other nursing home residents are being overcharged. I guess the pendulum swings both ways.

    • I_hatemyjob says:

      As a pharmacy we can not change the quantity that was written by prescribers. The only time that can be changed is when your insurance does not cover for 30 days supply then we have to change to 30 day even the quantity was written as 90 day supply. As for 31 days supply, yes some prescribers did do that for the month of January, March, May etc, for those months that have 31 days. But here comes another issue, if the supply is based on the day of month then do we need to count 28 for February and 29 days supply for every four year??? Not to mention when I count 31 for the month has 30 day do I count 29 for the next month refill????

    • Kevin The Tech says:

      Why do you people always think that it is the pharmacy that is charging you what they do? 31 days in a month logically would mean filling 31 days worth of medication that is sent to the insurance and we receive a copay back. We don’t get little notes from them saying “hey, since this is over 30 days she is being charged two copays” we had a patient here in Ohio that no one realized they were paying two copays when the Dr called in a script for 31 days and we filled it. Even the patient didn’t know. The sooner a lot of you consumers realize that the pharmacy doesn’t art what you pay at the window, the easier it will be to work together for your healthcare benefit.

    • pharmacyphil says:

      Some insurance providers require a 31 day supply for a single copay, others will charge two copays if 30 days is exceeds. We as pharmacists have the lovely task of safguarding against the two copay amongst the ton of other bullshit piled on a daily basis.

    • smartTech says:

      That isnt a pharmacy scam…that is the insurance billing her two copays for the 31st day. Tt happens when you unit dose for months with 31 days. trust me, if we could we wouldnt do it. She needs long term care coverage on her part d plan. Ask the nursing how to fill in 30 day cycles. She does have rights. Talk to the adminastrators.

  27. Bri says:

    I love you Angry RPH!

  28. da man says:

    Can I put dat RTS Vicodan on my foo stam? Ize promise not 2 abuse. I No they say Bray. You say Isle 2.

    • BandAid4RiteAid says:

      Eye gives u what u wunt, Bro. U wunt som Vics, eye set u up. Da man sayz pleeze da costumer, end eye do dat 4U. Eye gives U 10 vics 5/500 4 sum fuzzy dice, bro.

  29. PA Honeybee says:

    I totally understand your position, when I was still in “the pharmacy box” (it was sooo tiny) I hated going through the shelves, making calls, and reversing claims. You are right, we work hard to do our jobs and it sucks having an armload of RTS meds!

    I once had a woman who was discharged from the hospital with a nasty MRSA infection, she begged us to get the med for her, and we bent over backwards to get her Zyvox Rx ordered, approved, and filled only to have her NOT PICK IT UP! We called her after a few days, once a week passed, the following week, and you know what she did, she said we were harassing her about her medication THAT WAS PAID FOR BY MEDICAID!!!!!!!! I wanted to yell this at her so badly, “Ok, then have fun developing sepsis, and die from your selfishness since our harassment (which was concert) didn’t make a difference!

  30. Ryan says:

    How do you RTS compounded medications?

    • PharmIntern says:

      Same way as any other med. Only difference is, that bottle of Magic Swizzle we made for patient X with the odd proportions will sit there until it expires and we have to throw it out, given that no one else will need anything but the standard 1:1:1 ratio.

      Even with the standard formula, we never even get many MS rxs at all.

      Fuck RTS.

  31. pharmddd says:

    Kattie- we dont ahte our jobs. We hate idiot patients and those that make it much more difficult than it has to be, And tell your grandson to find a different proifession, hell never get a job after he graduates the market is saturated.

  32. niterph-pacingmyselfsargeant says:

    What is the name of this blog? Hell yes we hate it. I hate it so much I went to the night-shift to avoid as much DNA as I possibly can. In the morning, when the day-shift pharmacist comes in to relieve me, I hand off the baton-of-pain to them…then I go home to drink alcohol because I saw and interacted with several lovely customers at night. I’d rather dig ditches in 90 deg heat…but only a dry heat.

  33. I_hatemyjob says:

    Katti,
    If your grandson has a good GPA such as 3.8 then ask him to study hard for MCAT. I believe there is a seat in the medical school is waiting for him either in US or Carribean. If he is not so knee for MD after his last name and his GPA is around 3 then DO school is a another option. As the option of a pharmacy school to become a pharmacist, there is no job for the future.

  34. PharmGamerKid says:

    I hate auto-refill and how corporate make us push it on our patients. I swear, there are so many drugs I have to discard (after refunding money to the patient) because it was on auto-refill, they picked it up, and realized they no longer use it when they got home :P

    And don’t you hate the people that come in RIGHT AFTER you have rts-ed their 15 prescriptions?!?

    @Ryan, we don’t compound the medication or mix the suspension until the patient has already paid for it.

  35. Kevin The Tech says:

    We just “love” RTS here in Ohio. Not only does our system call you every 4 days your script is ready, but you have a full 12 days to pick it up. If you don’t however, we will RTS it after 12 days. Now here is the kicker. A year or so ago, Ohio BOP decided that those RTS medications can’t be placed back in the stock bottle and must be destroyed after 1 month if they are not used. Recently though they have increased it to a year, thank god.

  36. Wife of PharmaMonkey says:

    I’m not a pharmacist, but this is just a hunch… I bet there aren’t many NARCOTICS that end up in that RTS bin, ‘eh? No one seems to drop off THOSE scripts and then waddle off to shop, only to forget to pick them up later…

  37. lurkerpharm says:

    So you dump the RTS vials back into the stock bottle? What state are you practicing in that would allow that? Is your pharmacy beyond slow that you know for certain that the RTS vial’s pills have the same lot/expiration as your stock bottle since it’s been sitting on the shelf for a long time?

    • I_hatemyjob says:

      Let’s just look at a very common practice. When you dispense a medication from two different bottle do you check lot number/expiration date of each bottle or you just assume both have the same lot number/expiration date?? Of course if you are working at a very slow pharmacy you certainly would check???

    • kdog909 says:

      Honestly, WHO FUCKING CARES. (just kidding, lol)

  38. Countbyfive says:

    I always had the customer coming to pick up the after we had just rtsd it. Then theyd get mad now that it wasnt ready. Now we have someone that calls the customers to tell they have to come get them. Course now we have people who r sooooo lazy that they wait for the person to call them and tell them its going to be rtsd before they even come in!!

  39. RetiringSoonRPh says:

    So at my company, we have shortened the time from 13 days to 10 days that a script can be left set up. So we have gone from 5-10 RTS per day to 15-30 RTS. Shows how long people take to come in and pick up their Rx’s. The real sad part is corporately our staffing hours are reduced for every RTS, they are not considering the initial fill as work.

  40. Xitree says:

    I think I have that beat I went from one retail pharmacy hell- mart to a small retailer that actually has a drive up pharmacy so the lazy bastards that live off the system don’t even have to get out of the cAr to get their controls which is over 80% of what we fill being that we can throw a stone and hit the health center home of the service for free give them whatever they want so someone else has to smell their stench. And of corse they seem to think it works like mcdonalds they place their order and 30seconds lAter it’s done and I their hand. Ha ha ha cute fucking joke.

  41. xitree says:

    The drive up pharmacy window is by far the worst invention to date the lazy bastards no longer have to get their weekly exercise waddling to the counter to drop off their control rx’s they can just drive up and assume it works like McDonalds and 30 seconds later your order is ready. HAHAHAHA cute joke. never thought i would miss hell-mart i mean wal-mart retail pharmacy.

  42. cardsfanbj says:

    Automatic refills make it worse. Then you get the phone call “I got a call from you saying I had a prescription ready, but I didn’t call anything in!” And you have to respond, “Sir and/or Madame, you signed up for automatic refills,” possibly followed by “The call you received actually said we had to contact your doctor because you were out of refills, [which you would have understood if you actually listened to the whole fucking thing or, more likely, you probably didn't even pick up the phone and just saw the caller ID said '(store name)' and just assumed - and you know what happens when you assume - that you had a prescription ready, you ignorant fuck]”

    Oddly enough, my store has its share of RTS’d Adderall and Ritalin, for God-knows-what-reason. I don’t understand it…

    • Wife of PharmaMonkey says:

      RTSs for Adderall and Ritalin? Sounds like they’re too distracted and busy bouncing off the walls to go in and get the meds that will make them less distracted. No irony there, ‘eh?

  43. on_the_edge says:

    I agree. The drive up window took a bad situation and made retail pharmacy even more miserable.
    I am waiting for an “insert your arm slot”, so you can give a drive up flu shot, check blood pressure, and blood glucose. Usually, the patient’s arm is hanging out the window anyway on the approach either waving a credit card, rx, or getting the buzzer finger ready.

    I’ve tried numerous questions to see what usually receives the best response in drive up. For example, sometimes I will ask “when would you like to pick this up? (Buzz)… Most responses are Now, 5 minutes, or as soon as possible. However, stating the current wait time right from the beginning is a better approach. “Hi, the current wait time is 15 to 20 minutes.” Patient responses usually includes “It takes that long?”, or “what’s the hold up”. And finally, asking “Are you going to wait from this?” is the worst question to ask.” The common answer is “No, I am going to come back for it in a few mminutes.” This answer makes me CRAZY.

    So, to make them have a stall out, asking ” Are you going to wait for this or come back later?” shorts some brain circuits…. can’t compute…..can’t compute…

    • KLS says:

      I usually say “The time is now 10am… when would you like to pick this up?” If they say “5 minutes ago” I ask them to provide me with a time machine. If they say “Right now” I’ll say “I can have this ready for you in X # of minutes.” If they say “Later” I say “If I have this ready for after 2pm, is that okay?”

      Always say “I will have this ready AFTER….” instead of “I will have this ready BY” and be very firm with the time :)

  44. Angry Baseball Bat Swinging RPh says:

    Pharmacist for 13 years here. If you want your grandson to loose their faith in humanity, steep in a haze of hatred for 40 years, and avoid long term relationships with women, just because he can’t handle drama both at work and at home, then please steer him in some other direction. If you’re going to waste 100k on school then have him be a surgeon or histologist, engineer, architect or college professor – something where there’s some respect for professional ability involved. Or just invest that 100k into the stock market for 20 or 30 years, and let him retire early as a millionaire after being a bar tender or a car salesman for that time.

    I just do the pharmacy part time, because that’s all I can take. I pursue non-pharmacy, intellectual interests that don’t pay very well, but from which I achieve infinitely more respect than from the world of pharmacy. Hope I’m making sense here; just thinking about pharmacy makes my blood boil.

    -Angry Bassball Bat Swinging Rph, graduated with honors and a scholastic award, in the top of my class of 1998.

  45. ashley cummings says:

    This whole article is childish and upsetting. It is people like you who should not be in the healthcare field. I have one question. Do you own a pharmacy? Is it in your name? No. You are nothing. Don’t take to websites like this to vent about your horrible job. If you don’t like it, guess what? They are always hiring burger flippers…which f.y.I. is probably a MUCH harder job than you have. Grow up and be a mature working adult.

    • got the oc's? says:

      LMFAO- Don’t worry aboo(see above comment) will have our jobs soon enough. He will be more than happy to get your medication ready in 15 minutes or less. If you don’t understand him please call that 800 number and the pharmacist you can understand will explain everything after your 45 minute wait on hold.

    • THIRTYYEARS says:

      I think Ashley Cummings has vaginitis.

  46. angrypatient says:

    AP,
    You think you are so intelligent but by what you said in your less than 1% remark shows you r actually stupid enough to let the media brainwash you into thinking everyone that needs controlled meds are evil vampiric criminals. I hate discrimating pharms like you. I hope one day you need them and see what it feels like to be treated suspiciously by assholes whos job is to dispense meds not dirty looks eye rolls and opinions. Do your job and dispense, you are not a babysitter. Don’t discriminate and treat people like children and assume everyone wants to get high.

    • PA RPH says:

      Angry Patient,

      Shovel shit all day long. Eventually everything will start to smell like shit after a while.

      Not everyone that needs controlled meds is “evil”, as you claim. But a good chunk are either addicted or selling them. And they make it obvious. Don’t draw attention to yourself and there won’t be a problem. There are plenty of legit people who need benzos, pain meds, etc.

      This site is for PHARMACISTS to VENT FRUSTRATIONS. Recognize.

    • Srs12 says:

      Yeah, angry patient, right on!! Angry pharmacist, I understand your frustration; you also write well; however: not very cool to treat your clients like that. Angry patient is right – try to be in our shoes. You won’t like it, I guarantee it. Thanks for reading.

  47. Jes says:

    I worked at a small pharmacy and we had to make “courtesy calls” for each prescription on day 3,7 and 10. The funniest response to “I am just letting you know you have a prescription ready for pick up” was “No I don’t. I don’t have anything that is ready… oh wait I am out of all nine of the prescriptions that I take”.

    Then there are the people that are offended that you called “No, you are wrong, my doctor took me off that medication, how dare you mildly inconvenience me with your call, no one authorized you to fill that, no one told you to do that”. Well actually, your prescriber did when they gave you refills and you did when you signed up for autofill.

    Then there are the people that get the message and come into the pharmacy to yell at the pharmacy staff because we filled something they did not want instead of just calling. I know you have a phone, I know that you are capable of using that phone since you received the message, and yet you still drove all the way down to the pharmacy so that you could yell at me face to face. These are the people that yell at me for wasting their time. In reality they wasted their own time because they could have just called us and told us to put the RX back or they could have done absolutely nothing and we would have eventually returned their rx to stock.

    My absolute favorite are the people that come in and say “Well I saw that you called but I didn’t actually listen to the message”. Well that is great, I was calling to let you know that your MD denied your refill request. “What did you do wrong that made my MD deny this? Did you call them? you said you faxed them but you never left your computer so I absolutely don’t believe that you faxed them”

    The most annoying are the people that come in two weeks after the last of our 3 calls and say “well you said something was ready, but you didn’t tell me what medication it was on my answering machine so I don’t know what medication I need. You really should tell people what medication it is because it is really annoying when you don’t”. Well you really should keep better eye on your own meds and have you ever heard of HIPAA? “No, but can you just fill all the ones that I need, I mean it is not that hard just look at my record and fill the ones I need.” Well your profile is 80 pages long and I am willing to look at exactly 1 of those pages.

  48. A Future Pharmacist (Hopefully not retail!) says:

    Interesting article. I find that your blog has been lending me some insight into the pharmacy profession.

    I’ve never had experience in a pharmacy and I don’t know anything about their laws, but this sounds like a relatively simple problem to fix. Why can’t the pharmacies just make a no-refund policy for the dispensing/labor cost on the patients and their insurance companies? Force the patients to pay up front, and let them know that if they don’t pick it up in a certain time frame, their medication will be returned to stock with NO refund on the dispensing/labor cost, and not even to their insurance company. If the patient has insurance, the insurance companies would increase the patient’s rates if they frequently don’t pick up prescriptions and end up having to pay for them again.

    I dunno. I’ll probably get rants about how many people can’t afford insurance as it is, how insurance companies already take advantage of their benefactors, blah blah blah. But at least it would force more responsibility on the patient, who I think really SHOULD be held accountable for doing stuff like this.

    • I_hatemyjob says:

      No-refund policy—- Even without this policy in place, if you do that I guarantee you will be out of your job very soon. Every PDM in chain stores will always tell you just keep your customers happy.

      Pay up front—- Are you crazy?? 90% of patient pick up their medication based on how much they have to pay when you ring them up. If it is too expensive they can live without it. Ask them to pay up from??? in no time all your prescription will be transferred out.

      MY future colleague, You had better study really hard and get a good residency training. After your residency training you can find a hospital and hope someone would call you Dr….., yes you will have a degree of doctor f pharmacy.

  49. lunatech says:

    I SWEAR that this NEVER failed!! I actually had several patients of whom i rts their meds the SAME CRAPPY DAY!!! So yeah , some of those compounds had to be re-done cause, of course,they never forgot that the medication wasnt fresh !! Damn idiots!!

  50. Cari says:

    What gets me as a consumer is the robocalls. My office reissues blackberries (& their numbers) so for the last 3+ years I’ve been getting robocalls that the previous number holder’s prescriptions are ready. I have called and gone in to tlel them they have the wrong number – to no end. They cite HIPAA, which I understand, but I also would bet dollars to donuts they’re violating HIPAA by telling me “my” prescription is avl for pick up even though I’ve told them they’re calling the wrong number.

  51. Teched Off says:

    In my pharmacy any time we rts a narcotic, especially a C2 we always say “hmm someone must of died” By the way anyone who is bitching about people venting about our shitty jobs either don’t work in a pharmacy or you are just retards.

  52. Why should they care says:

    In situations where patients are diligent and know about their meds in quite detail and do not want to use the autorefill system, what do the corporate lackeys say? They stll push the autorefill system hard. All they care is about numbers. They want to look good before their bosses. Here autorefill is @30%, 40%, script volume has grown tremendously. To me that is bullshit, the pharmacist is a professional who has to adhere to fundamental principles first. A patient can be on autorefill, pickup all meds, and receive a great score for compliance. But that is half the story. The other half involves, whether the patient should even be on all those meds in the first place,whether the patient is taking the medications at all once picked up and more. The corporate nitwits should understand these fundamental obligations first. High volume is not great care. A good pharmacy practice is one that creates an environment where patients are empowered to take active role in their health care, understand in detail the purpose of their medications and how to take them, and map out goals for better outcomes in their health.

  53. Linda says:

    So true!! Auto-Fill causes so many of our RTS, yet many patients want to know why their scripts are not ready when they insist that they are on Auto-Fill. When I check their profile it’s either that med is not on Auto-Fill or they did’nt get their lazy ass in the Pharmacy in time to pick it up. We delete Auto-Fills for a particular script when doing RTS because it cuts down on RTS. Let’s just not offer Auto-Refill since so many patients don’t have the brains to deal with it.

  54. Mr. Bean says:

    Pharmacists are nothing more than a group of undereducated, overpaid monkeys. How many other professions pay six figures to someone for counting items and doing 3rd grade math? It is a burden on our health care system.This needs to stop! Don’t tell me that you are preventing drug errors because MD’s don’t know what they are prescribing. Enough of that BS! I am working diligently to reduce pharmacists’ hourly wage to $30. I think this is reasonable based on the skill set. Perhaps even overpaid.

  55. Srs12 says:

    Pharmacists get paid more than $30/hour? Wow. Just wow.

  56. Ashlee says:

    I am also a tech and I am grateful for all my good patients. (Although there are a select few that do make me want to scream.) I had an instructer that introduced pharmacy as the last place the customer wants to be if they are sick so yes they are irritated yes they probably did just sit in an er with a screaming
    2 year old only to be told that their child’s medication needed to be ordered. But I mean if their rx doesn’t have a co-pay and its time to be put back after a week why not call the patient and let them know that hey you didn’t pick up your meds but ill go above and beyond for you and mail them. In this economy and people not wanting to pay a small copay for their meds because that 4.00 could be their last for the week why not look at it as them not being lazy but maybe not having a way to get to the pharmacy or simply not having the money to pay for it. I guess I’m lucky our patients at least give us a call to say hey I can’t afford it right now but I will be there to get it.

  57. Non-Angry Patient says:

    The days of the apothecary compounding blue mass and retorting the essence of foxglove are pretty much over; pharmacy is essentially a retail business. Yes you have to get an advanced degree and probably remember some stuff from the PDR, Merck Index, and/or whatever else they make PharmD students read these days. Yes, Rx dispensing has more complexity than selling boxes of donuts at the 7-11. Even so, modern pharmacies primarily stock and sell packaged patent medicines like any other brick-and-mortar store. I do not doubt that RTSing medication is an annoying pain in the butt,. However I am sure any random Wal-Mart employee could go on just as long about the BS returns they deal with, the crackheads trying to scam them, the abuse they deal with on the phone, etc.

    To the people shaming these angry pharmacists: THIS IS A FORM FOR PHARMACISTS TO BITCH ABOUT THEIR JOBS. Save your self-righteous anger for when an actual pharmacist is rude to you in person. There are forums where waiters hate their jobs and insult their customers – forums for angry mechanics and the idiotic things they see – pretty much everyone who works for a living is going to need to blow off some steam about it once in a while. I find these rants informative and entertaining. Don’t let it get under your skin and let the angry pharmacists get it off their chests.

  58. jagg says:

    I really enjoy your blog! All of this is giving me the cold, hard, blunt truth about what I will have to deal with day in and day out. It is not scaring me out of it just because I am passionate about chemistry and science, plus I have worked in the health profession. But thank you for a refreshment.

  59. so tired of this says:

    LOVE IT!!!! you go girl

  60. Sympathetic Patient says:

    I’m not a pharmacist, but I’ve got to say that anyone who doesn’t understand and sympathize with what you’re going through after looking through this site is short on brain cells.

  61. wiserph says:

    Tell them it is illegal to return the rx once leaves the pharmacy.
    If your company wants you to take it back for the sake of customer service, then send them as damaged rx. Just stick it back to greedy coporation but don’t restock them because someone will turn you in for reward money.

  62. wiserph says:

    Mr. Bean should eat his own poop. Or better yet, Kill your self because this world will be better without you!

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