A wise man (OK, its my employer, fine) told me that the smartest investment a business can make is in its employees.  That’s right, happy employees mean productive employees which are good for the customer, business, everyone.

I sure as shit wouldn’t be happy if my employer rewarded complete dickhead patient behavior with gift-cards.  In fact, I’d feel like my employer feels that a shitty patient attitude is more of an asset than the feelings of its employees.  A feeling that my professional opinion/ethics is worth less than a $10 STFU gift-card.  Chain pharmacists, I don’t know why you put up with it.  Oh, its because they blew a bunch of smoke up your ass when you were in school (when you thought you knew everything), offered you a fat sign-on bonus in return for years of slavery, and now you’re stuck with a tech who paid $20k in schooling but asks you daily what the trade name of hydroxyzine is.  Lame.

So I hope Walgreens, Rite-Aid (15 mins!), CVS and the like need to listen the fuck up, because I’ll tell you why the profession is going down the shitter (and why we are treated so).  The mighty bribe..er..gift cards.  CorpoChains are shitting in their own beds for the sake of ‘loyalty’.

At my store, we have no gift-cards.  You treat me (or my staff) like shit and we politely ask what pharmacy you would like your Rx’s transferred to.  If you continue, you get the front door opened with your face.  We don’t reward asshat behavior (unless we REALLY REALLY FUCKED UP, then we deserve it), most (if not all) independents operate the same.  Its just common business sense!  If the pharmacy fucked up – sure, throw them a gift card to say that we’re sorry.  However word from the trenches is that they are throwing gift cards away to people who have complaints that are in no way the fault/responsibility of the pharmacist nor the pharmacy itself!  Chains, grow a pair of nuts and realize that the customer is usually dead-fucking-wrong!

Hey, if you are pissy because your doctor hasn’t responded to your vicodin request then you are FREE to go get a new Rx directly.  Upset because you have 0 refills? Your bottle clearly stated that fact when you picked it up, try reading it for once.  Don’t like this whole novel concept called “responsibility” and “planning ahead”? Go get your own MD license and you can write your own prescriptions.

Unhappy that we didn’t have all 120 of your Xeloda?  Are you unhappy that the pharmacy TOLD you that this was a special order and to call a week ahead (which you promptly forgot/ignored)?  I’d be happy to order you a year supply if you want to foot the $20,000+ tab and I’ll keep it safe for you.  Maybe a little inconvenience will pound into your thick skull to do what we tell you next month.

Pissed that we didn’t have the full amount of a trade-name item that only YOU take (and you didn’t call ahead like we asked)?  Well, I’m unhappy that my grocery store doesn’t have a certain brand of salad dressing in stock, yet you don’t see me raising a stink and demanding compensation via gift-cards.  Call ahead.

Pitching a shit-fit that you drove “all the way across town (2 miles)” to find that we’re still waiting for the refill authorization on your pain pills (even though the 10 maintenance meds are ready to go)?  Its called a phone, you have one in your pocket, its nicer than mine.  Amazing how you can know everything that your baby-daddy is doing behind your back yet you are unable to make a phone call to the pharmacy to see if your crack got approved.

Whats the solution to all of these scenarios?  Gift-cards to the loud-mouth crackhead by some ignorant store manager who couldn’t be a pharmacy tech if his/her life depended on it.

The chains are doing nothing but demoting the profession (if you still want to call it that) of pharmacy by rewarding patient complaints.  If your dog pissed on the carpet do you give him a treat?  The chain stores do! Rewarding such piss-poor behavior just breeds more bad behavior.  Shit-hole patient chainitude (that’s chain attitude, I’m so clever!) behavior spills over to independents, and god dammit we don’t give out fucking gift cards nor do we want your douche-canoe “Eye wanna gyft carrrd” patients!

So my in at the Low-Stock-Price-Leader says that Rite-Aid has this 15 min guarantee for when your vicodinprescription will be done.  If you don’t get your Rx in 15 mins you get a $5 gift card (insurance problems don’t count, some restrictions apply, see your friendly Rite-Aid associate for details, blah blah blah).  Now considering how short staffed most chain stores are, I’d rather them keep the $5 (the going rate for almost 5 shares of stock, no bullshit), have them take as long as needed, and have my Rx be correct (ie: not killing me).  In fact, this whole 15 min bullshit really pisses me off.  Who cares if your Rx wasn’t done in 15 mins or less (sounds like pizza delivery).  Guess what Rite-Aid; people die due to medication errors, people don’t die from a cold pizza. If you want to hold your pharmacists to the same standards as a pizza-worker, then expect the same quality of service of a pizza-worker.  Hope the impending lawsuits don’t push your stock to the point where you need to PAY people to claim ownership of it.  Oh wait, its $1.11 a share, strike that last statement.

In all honesty, I really do feel bad for the pharmacists, tech, and clerks who have to deal with their employer who puts the opinion of the public over their own employees.  Its one thing to offer something to a patient as compensation for a mistake, an oversight, or just plain forgetting (nobody shit smells better in this regard), but for a 15 min guarantee?  Way to value patient safety at a whopping $5.

By the time you read this, the Vaccine = Autism published by the BJM will be old news (Yes, I do write a bunch of rants at once and have them post at a later date).  However lets take a closer look at this whole situation.

Lets keep in mind that I don’t belittle Autism or think its “not important”.  I’m hoping to not only find out what the cause is, but how to prevent it.  Autism, like Down Syndrome, happens and we aren’t sure exactly why or how.   Take a look at how many drugs are out there (that kill people no less) that the mechanism of action is “Undetermined”.  Are you throwing a shit-fest over those? No.  Is some random dipshit actor standing on his/her soapbox about that? Nope.

First off, Jenny McCarthy.  The woman who is best known for her blond hair and big fake tits speaks the gospel about how vaccines contribute to autism. The whole fact that people LISTEN and BELIEVE her shit makes me want to blow the brains out of 99% of society.  She should stick to what she does best, being being eye-candy.  We don’t need “actors” to be the voice of medicine, politics, or anything else that they know jack and shit about.  Lets be realistic, if you listen (and believe) any non-medically trained person’s bullshit about medicine, you are an idiot. Do I ask the random homeless guy on the street how to fix the breaker box in my house?  No. Do people come into my store and ask me how to replace the water-pump in their Escalade?  No. However some random dipshit actor “speaks out” on a topic and people run and proclaim the word like it was given by Oprah herself.  Yes, it sucks that her child is autistic.  It sucks that /any/ child is autistic.  However it sucks MORE that kids need to suffer a preventable diseases because their mom listens to such propaganda given by a non-medically trained person.  I’m sorry Jenny, but I am no longer fapping to pictures of you out of sheer disappointment.  I hope we can still be friends.

Second on the chopping block, the Lancet.  I had somewhat high regard for the Lancet, having used their studies while I was in school.  How in the hell could they let such a bullshit study be published? A study group of 12?  A high school science project has more people in their study group!  But oh-no, its the whole “think of the children” mentality that got this clusterfuck of a study published vs good logical science.  Good going Lancet, now you can “think of the children” as the unwashed idiots don’t immunize their children and they die a preventable death.  I’m planning on releasing a study showing how Vicodin and Soma use cause laziness and stupidity.  My sample size is 20, I hope you publish my study.

Third, and most favorite: Andrew Wakefield.  Dude, when you publish a study with a sample group of 12 on a medication that MILLIONS and MILLIONS of people have received without incident, didn’t you take a step back and think to yourself “Man, maybe something is a bit wrong”.  No, you didn’t.  You published your bullshit to the Lancet, got your 20 seconds of fame, freaked the fuck out of a bunch of ignorant dipshits because you are were a licensed Doctor and thereby had the inherit trust that goes along with the degree.  If you were selling penis pumps (because thats really all you can do now), I wouldn’t even buy one of those from you because your study group would be 12 men who used it!  You did a huge disservice to the profession of medicine.  Your fellow colleagues hate you, nurses and pharmacists hate you, and to be completely blunt you and the Lancet should be brought up on criminal charges for the damage you have done.  You should go have sex with Jenny McCarthy so maybe the common sense recessive trait could be expressed in your children.

Fourth (and finally) the parents who refuse to immunize because of Autism:  I’m a parent – so this hits close to home. To be completely honest its not the job of the government nor any governmental authority to make you vaccinate your child.  Its your child, you can do whatever you want.  However, that being said, if your child develops any preventable disease because you decided to listen to an ACTOR via the INTERNET vs listening to your DOCTOR (I can see how you can confuse the two, they end in -CTOR) YOU should receive zero state aid while the CHILD gets the treatment he/she deserves on our dime (its not the child’s fault their parents are dipshits, so why should they get shafted out of treatment?).  That’s right, no welfare or any public assistance for YOU because YOU decided to not listen to someone who deals medicine for a living.  You can sleep soundly in bed listening to your child squeal with pertussis knowing full well they won’t get the evil Autism because of your good judgment. Right after that, please stick a road-flare up your vagina, because we don’t need more idiots like you breeding.

I will commend BJM to putting an end to this madness, unfortunately its too little too late.  The damage has been done, the lines have been drawn, and you aren’t going to change the opinion of the uneducated idiots.  After all, you are just a “propaganda machine for big Pharma”.  Oh, and calling Jenny McCarthy an actor is a stretch, even in my book.

But wait! Theres more!  For your enjoyment, straight from YouTube, I present my heros Penn (he should have been a Pharmacist!) and Teller’s episode of Bullshit about this very subject:

Part 1:

Part 2:

Everyone has heard that Pharmacists are one of the most “trusted” professions.  Sure nurses yanked that out from under us a number of years ago, but the fact that we are still on the “trusted” scoreboard started to make me wonder what exactly about what we do makes us so “trusted”?

Patients dont trust us.  They yell at us over their copays thinking that we are making a HUGE profit from that measly $50 copay when in fact we are barely breaking even.  They whine and bitch and think we are lying to them when we say that their pain pills are too early.  How many times have we caught a possible serious interaction only to have the patient demand that we fill it anyways because they don’t wish to wait the extra day for us to confer with their doctor (then transfer it out when we refuse)?  How many of us have suggested an OTC product only to have the patient pick the one with the shiny packaging that won’t do a damn thing for them (but Airbone was created by a SCHOOL TEACHER!).  How many times have you told mothers they cannot use a decongestant elixir on their 2 month old baby only to have them grab it after your back is turned?  How many times have we given them medications so they won’t have to sit in the ER only to have all of their Rx’s transferred to a chain for the coupons/gift certificates the very next day?  Someone who is “trusted” doesn’t get yelled at for non-covered drugs or for insurance-company doughnut holes, they should accept what we say (its not like we do this for a living or anything) and go on their way.  How many times have you seen a patient dump all of their pills right there on the counter only to count them (and proceed to dump them on the floor and demand new ones).  How many times has your drug knowledge been called into question because of “my friend said” or “I read on the internet”?  I guess we are trusted enough to know what isle the paper towels are on or to count the blue Lortabs vs the pink ones.

Doctors dont trust us.  95% of them won’t allow us to switch to a covered drug in the same class without going through 10 fax backs that involves their non-medically trained front end staff relaying incorrect messages and completely wrong information.  They dont ever get on the phone to speak to us because they are “too-busy” seeing patients and cant spare the 10 min’s to discuss an interaction that may kill someone (yet they take an hour lunch break every day.  When is the last time YOU got an hour lunch break?)  Yeah, sure they may be “reviewing paperwork” during that hour, but how many times have you gotten mindless “OK’s” when a valid question is written on the refill request in black sharpie?  How many doctors will allow you to use your knowledge over being their human shield/proxy when they piss a patient off?  How many doctors will stand with you against narcotic diversion rather than just rolling over and demand we fill narcs early when the patient starts to whine?  How many times have you gotten a call from a doctor wanting to discuss the narcotic use of a patient and what WE can do to help the patient (I can count the number of times this has happened on one hand, minus a few fingers)  Yeah yeah, doctors are busy, excuse me while I take care of your patient’s issue while I fill the other 1000 Rx’s that your other patients are screaming at me about because they aren’t ready 30 seconds after they call them in.

Insurance companies don’t trust us.  They make us go through mindless audits where they nit-pick /everything/ just so they can yank that drug cost right out of our checks.  We cannot call them for a prior auth even though we have a complete Rx history for the last 10 years AND have doctorates of pharmacy (or 20+ experience in the field) but rather hear some high-school dropout or some community college graduate tell them the exact same information read from a chart.  Our services and education are worth a dispensing fee that is less than the pizza boy who delivers in 30 mins or less.

State Boards/FDA don’t trust us.  They are the first to nail us to the cross and pull our ticket at the slightest word that someone has gone wrong.  They won’t stand up for us against the PBM’s even though THEIR fate is directly tied with ours.  Ever been inspected by the state board?  Ever gotten some minor-ass infraction just because they needed SOMETHING to ding us on to justify their jobs?  “Your fridge is 1 degree above the USP published standard, ignore the fact that I had the door open for the last 5 min’s looking for outdated insulin”.  They make us cram so much information on our Rx labels that it takes a masters degree to sort through all the tiny (and BIG) print to find when a drug was last filled.  We have to hand out STUPID medguides (more on this on another post) that list every side effect known to man that just scare the patient into not taking the drug.  To hell with actually US TELLING them what they need to know!

In fact, the only people who trust pharmacists are other pharmacists SOLELY because we are in the same trench.  Sure patients that you KNOW and have cared for will trust you, but its mostly out of professional friendship gained via feats that you have gone completely out of your way to do for THEM (illegally most likely) vs the inherit trust earned through a pharmacy degree and license.  Oh, don’t piss them off or they will drop you in a hot second for that chain giving out coupons and gift cards.

Not to belittle or devalue the hard work that nurses do, but what do they do that makes them number one in the “trusted” list?  The ones I know follow the doctors orders and care for them while they are in the hospital.  Their “trustworthiness” is not plugging the wrong IV (that has been scanned 100 times through a bar-code system and prepared BY A PHARMACIST) into the IV tube.  They make the patient comfortable and act as proxies to the doctors (the times that I or my family have been hospitalized this is what I’ve seen.  Sure its important, but #1 on the trusted list).  Dont we do the exact same thing?  I mean really, in a hospital setting you’re at the mercy of the nurse since you obviously cant walk around shouting and demanding stuff like they do when they walk into a pharmacy.  Nurses have a little light and call button to summon them, we have a phone and a pissed off patient storming in through the front doors demanding to know why their copays are “so high this month” (when they paid the SAME last month).

Pharmacists are like the kickers of a football team, we either save the day in a pinch or cost the team the game; in both cases we obviously didn’t win/lose fast or cheap enough.  Our shit doesn’t smell better or worse than ANYONE in medicine, yet we’re the human shield.

Oh hell, what do I know.  I just put vicodin and soma in little bottles not fast enough to keep the unwashed masses from bitching and moaning.  Yeah yeah, it’ll be ready in 10, your ride is impatient.

This is taken from Apothecary Tales.  Its too well written and too funny to have me just skip over it:

Here are a few things that I have written to celebrate the overly-medicated holiday season:

The 12 days of Crackmas:

The night before Crackmas:

Merry Christmas to All!  May all your early refill wishes come true!

Im leaving town right now, will it be ready in 10?

Pharmacy tech schools/programs are cropping up around here in California like herpes after the prom.  I, for one, am sick and tired of these schools duping young ignorant students into handing over their hard-earned money to get some half-assed education when they can avoid it all together.  Thats why my friends, I am going to tell you how you can get your pharmacy tech license WITHOUT setting one foot in some useless program that costs 20k bucks.

Back before 1/1/2004, one could work in a pharmacy as a tech-apprentice and get a license after completing 1500 (or something like that) hours of real-life work.  Personally, I think this is the BEST way one could be a tech since you are being taught exactly what you need to know, what you can and cant do, and all of the things that you will be doing on a daily basis.   These were the glory days when men were men and the generic quinine flowed like cheap booze!  All of this is different now, read on.

Now this is California specific and information that the schools do NOT want you to know.  Here we go.

According to the Calfornia Board of Pharmacy tech license requirements.

Effective January 1, 2004, there are only four ways to qualify for pharmacy technician registration (California Business and Professions Code section 4202). California law now requires that an applicant for a pharmacy technician permit must meet one of the following criteria:

1. Have obtained an associate of arts degree in pharmacy technology.
2. Have completed a course of training specified by the board (typically provided by employers under requirements of California Code of Regulations Section 1793.6 (provided below)).
3. Have graduated from a school of pharmacy approved by the American Council on Pharmaceutical Education or recognized by the board.
4. Be certified by the Pharmacy Technician Certification Board.

California Code of Regulations section 1793.6 describes the training courses acceptable to the board (item 2 above)

This training is:

1. Any pharmacy technician training program accredited by the American Society of Health–System Pharmacists,
2. Any pharmacy technician training program provided by a branch of the federal armed services for which the applicant possesses a certificate of completion, or
3. Any other course that provides a training period of at least 240 hours of theoretical and practical instruction, provided that at least 120 of these hours are in theoretical instruction in a curriculum that provides:
   1. Knowledge and understanding of different pharmacy practice settings.
   2. Knowledge and understanding of the duties and responsibilities of a pharmacy technician in relationship to other pharmacy personnel and knowledge of standards and ethics, laws and regulations governing the practice of pharmacy.
   3. Knowledge and ability to identify and employ pharmaceutical and medical terms, abbreviations and symbols commonly used in prescribing, dispensing and record keeping of medications.
   4. Knowledge of and the ability to carry out calculations required for common dosage determination, employing both the metric and apothecary systems.
   5. Knowledge and understanding of the identification of drugs, drug dosages, routes of administration, dosage forms and storage requirements.
   6. Knowledge of and ability to perform the manipulative and record-keeping functions involved in and related to dispensing prescriptions.
   7. Knowledge of and ability to perform procedures and techniques relating to manufacturing, packaging, and labeling of drug products.

Laws are stupid and boring.  Lets go through the possible avenues you can be on to become a Tech in California.

1. Get an AA degree in Pharmacy Technology.  What the fuck is Pharmacy Technology and why is it even an AA program?  It requires school and thereby money, moving on.

2. Have completed a course of training specified by the board (you can read the boring law as to what “Training” is).  Here is where all of the pharmacy tech “programs” come into play (along with #1 above).  They dupe you into thinking that you need to take their class to become a pharmacy tech.  Most schools tuition range from 15 to 20k bucks and will suck up a good 6 months of your precious life.  All to work in a retail pharmacy counting by 5′s.  Go you.

3. Have graduated from a school of pharmacy approved by the American Council on Pharmaceutical Education or recognized by the board. Translation: “You graduated from pharmacy school with a PharmD but you can’t pass the boards to save your life”.  Congratulations, you are the most overqualified pharmacy tech on the planet, here is your certificate on waterproof paper so your tears don’t smudge the ink.

4. Be certified by the Pharmacy Technician Certification Board.  Wait, whats this?  What is this strange PTCB you speak of?  Well, its a test.  Its a 90 question multiple choice test given at a hochillion testing centers around the state year-round.  Here is their online application to apply for this test.  Their requirements to take the test?

• High school diploma or its equivalent (e.g., a GED or foreign diploma).
• No felony conviction.
• No drug or pharmacy related convictions, including misdemeanors. These violations must be
disclosed to PTCB.
• No denial, suspension, revocation, or restriction of registration or licensure, consent order or
other restriction by any State Board of Pharmacy.
• No admission of misconduct or violation of regulations of any State Board of Pharmacy.

So, pay 15k and have information spoon-fed to you, or spend $200 bucks (the test is $129 of that) to get a PTCB study-guide from Boarders/B&N (search for PTCB exam), read it at home, take the practice test, then go to a testing center and get THE EXACT SAME THING.  PLUS if you pass the test you get a fancy CPhT after your name!  Just that information alone is worth it for you to buy Drugmonkey’s book with all the money you saved!

That’s it!  That is all you need to do!  Take a 90 question test and you’ll have your license!  No teachers! No books! No $20k financial-aid’s dirty looks!

Why am I doing this?  This is why; the pharmacy tech market in California is saturated to hell.  I get at least 2 applications a month from people looking for pharmacy tech jobs.  I feel horrible for some idiot who spent 20k bucks to have some washed up pharmacy-tech yap at them in a classroom to get a license that there isn’t any job demand for.  Its that simple.  These schools are swindling these students out of their money with promises to “get in on the pharmacy action” when there are already TOO many techs LOOKING for jobs.  I don’t think its right because the schools make it sound like their program is the only way to get a tech license, and that’s an outrageous lie.

I’ve worked with CPhT’s that just took the test, and externs who are close to finishing these ‘wonder-schools’.  I’ll be honest, both of them are shit-worthless walking in the door, with the CPhT’s a bit more useful than the externs solely because they have the ambition to study on their own.  I spend more god-damned time doing brand-generic translations, telling them they pulled the WRONG drug, and fixing their mistakes for them to be any worth to me.  What the fuck are these schools teaching these externs?  If you studied at home, I can sorta give you some lee-way.  But if you spent 6 months in a CLASS getting LECTURED on shit, you should damn well know what Keflex and Vicodin’s generic names are.  It’s gotten to the point where I refuse to take any tech-school externs because they end up COSTING me more time than SAVING me time by having them be there.  Yes, they are there to learn, but I am there to work.  Teaching time was in the classroom, “you should of learned this there”.

Now granted, some people learn better by having the information spoon-fed to them via a talking-head and homework than reading a book on their own, but is it worth 15-20k?  Honestly I want a tech that can read, understand, internalize, and apply on their own rather than asking me the same pointless questions every day.  I don’t have TIME to be a talking-head explaining them shit they should of learned at these fancy programs! I have work I need to do; and although these externs aren’t getting paid, they are preventing ME from doing what I need to get done with their should-of-learned-”How many mL’s are in a teaspoon?”-in-school questions.  At least intern pharmacists can take new prescriptions!

I’m waiting for the “Well, we all have to start somewhere!” excuses.  My preemptive response to your bogus statement: “You went to a SCHOOL to LEARN how to do this and you are SHIT-WORTHLESS.  You have FORMAL INSTRUCTION in this field and you don’t know your ASSHOLE from a 30 DRAM VIAL.  If I have to tell you one more time why HYDRALAZINE is not the same as HYDROXYZINE I am going to shove Drugmonkey’s Book (Go buy it) UP YOUR ASS.”  That’s right, his book up your turd-cutter.  Harsh, I know.

Another unrelated point on my refusal to take externs is a trust thing.  With a CPhT licensed tech, he/she is an employee.  We have paperwork on them.  We know where they live.  With an extern, its just a name from the school.  What prevents them from pocketing a handful (or a bottle) of vicodin during their X-hour externship stay at my store?  I don’t have the time to watch him/her like a hawk, and its my license on the line if something comes up missing. I’m not going to do a narc inventory after EVERY extern rotates out, so one of 12 externs/year could nab a bottle of vicodin and nobody could pin it on exactly who did it.  So I choose to just not deal with the situation at all.  Yeah, its a shitty outlook that really isn’t justified, but at the same time its my ass.

I get a lot of drug ad crap in the mail, but once in a while one really attracts my attention in a real ‘WTF were they thinking’ way.

Take Exhibit A:

Why is my mouth open when I have to poop in a pool?!?

Now Miralax is like Metamucil, it makes you poop.  Now I’m not sure what floats your boat, but if I were constipated and needed something to soften my food-baby, the LAST place I would want to be in swimming in a pool with my mouth open when the brown tide decides to come in.  Is the woman supposed to represent a poop floating in the water?  How does swimming in a pool go with constipation?  Maybe if her skin were dissolving in the water it would be more along the lines of the ‘osmotic effect’.  Maybe the force of the poop is propelling her through the water?  Should the water be going IN her butt?  I took it upon myself with my awesome drawing skills to make this ad more realistic:

Remember kids, when you’re straining like a puppy pooping peach stones, grab your Miralax and head over to the local pool, because nothing gets your bowels moving like an osmotic effect on both sides of the ole turd-cutter.

How many of those at home have gotten an Rx that looks something like this:

Wellbutrin 150 QD

or

Depakote 250 QD

or

Effexor 75 BID

Now how many of those at home after getting these prescriptions felt the urge to slam their face into the counter.  For those not in pharmacy (or for those douche-canoe asshat prescribers out there who are stuck in 1990) all of these drugs come in different formulations BUT in the same mg strength.  The regular-release is the SAME strength as the extended-release.  Its not like Coreg or Paxil which the extended-release dosage form has a different strength than the non-XR form. Hell, in that case its easy.  Dr writes for Coreg 20, and we know that he wants the once-daily CR caps (unless he wants the patient to start shaving the IR tablets, which would be rather funny).

Does the MD want Wellbutrin 150 SR given once daily? Or did he/she mean to write the once-daily XL?  Depakote comes in a 250 DR and a once-daily 250 ER, but depending on the patient they may want the DR given once daily.  I’ve seen Effexor plain given BID as well as the XR given BID.  Should I just guess?

Its shitty at best and outright dangerous at worse, and there is absolutely nothing that we can do to prevent this.  The only thing that we can do is to call the Dr, be left on hold while the patient gives us the “Why cant you fill it? It says the drug on the prescription!!” face, and be at the mercy of the *sigh* wonderful doctors staff to give us a call back saying “Doctor wants the extended release Wellbutrin” *headdesk* “IT COMES IN 2 WAYS!”.  What makes matters worse, is that ALL of these drugs are relatively new (compared to like Theophylline, Cardizem, or Verapamil) thereby removing all shred of hope that we could “guess” what the doctor wanted (since some doctors are stuck in 1990).  It requires a phone call/fax, which is just balls for everyone involved because 2 little letters could have solved this.  This isn’t something that the insurance doesn’t cover, this is just sloppy Rx writing!

Is there a good solution to this problem?  The one time we guess as to the release-mechanism it’ll be wrong, so there is no point doing that.  Of all of the examples regarding sloppy Rx writing, this has to be the most annoying for pharmacists.  I can deal with not having a quantity.  In some cases I can deal with not having a sig if I can tell from the quantity (I mean how many ways can a dentist give 28 amoxicillin caps?).  I can deal if you didn’t sign the damn prescription.  No IR/ER/XL/WTF designation? Boned-every-time.  Saving 2 seconds on your end just cost me (and the patient) 15 to 45 mins.

Just go give us one more kick in the balls, the patient wont understand what the problem is.  They see a drug, a strength, and some T’s with dots over them with some letters.  They don’t care about the IR/ER/XL/OMFG  dosage form, they want the drug on the prescription and they wanted it filled before they handed you the Rx.  Short of yelling at the doctor for omitting probably the second-most important piece of information on the Rx (yeah, that’ll teach him! *sigh*), all we can do is just bend over and accept the 30 min phone-call and hateful glares from ungrateful patients.

Time to set the record straight as to why I act the way I do (as if there was any question).

This isn’t new to people who follow me on Twitter or on Facebook, however I’d like to share with you something that I have made:

Stay tuned for more AngryTV (since the site that makes this is AWESOME) as well as some user submitted gems.  If you make one, comment with the link and I’ll post them if they are good.