Digging in Poop

Now I realize that people do strange things with their medications: flushing it down the toliet, dump it in the sink, vacumning it up, etc.
But there is one thing that I cant wrap my mind around: Digging in their poop for it. Now even I like to admire what comes out of my ass once in a while, but it stays behind the safety fluid before riding the final whirlpool to its destiny. Some people however are more “hands on”.
I shit you not (har har)! I get calls about people complaning that their extended release medication “isnt working” because “they found their pill in their poop”. Is this like an easter egg hunt? Do people feverishly dig in their poop looking for stuff like gold coins and pirate treasure? Its shit, let it go.
Of course we all know that most extended release formulations of potassium, morphine, etc will indeed leave an intact (yet empty) tablet in the ole poop, but try explaining this to a psychotic patient who digs through his/her own poop (heres a tip: you’ll have a better chance reasoning to the turd than the patient).
Then you have the truly sick. The people who not only dig through their poop, but save what they have found in their poop and bring it in to show you. We even had one patient take that poop-ahoy tablet and swallow it again! In fact, we even had one patient go through his/her mothers poop! What the hell is up with that?
So please, take our word for it when we say that you’ll find tablets in your poop. If you do indeed still wish to dig through your brown babies, then please call in your Rx and dont touch anything while you’re here.

Greed, stupidity, and phony Rx’s

Idiots, all of them idiots. Prescription forgers and people who cheat the system.
Today I had one helluva day dealing with the con-artists of the pharmacy world.
A patient came in today with an Rx for some Vicodin and Soma (what else). So I bill Medicare Part D for them, and lo-and-behold a month supply was filled at another pharmacy 4 days ago.
A quick call to the insurance company gave me the name of the other pharmacy that filled it. Here’s what the dumbass was doing.
Going to Doctor A and getting the Rx’s filled at Pharmacy A. Then they were going to Doctor B and getting those filled at Pharmacy B. With me so far?
Being a dumbass, last month she told pharmacy A (not my store) to use her Medicare Part D Card to pay for the Rx’s.. She then proceeds to bring Doctor A’s prescription to my store (Pharmacy B). See where this is going? I look at her profile, and I see that shes getting narcotics from both Dr A and B. Ah-ha!
There is a deep rooted joy when I get to call a doctors office to Narc on someone being a dumbass. I dont know if its the “oh really?” I get on the other end of the phone, or just the joy in crossing out the Rx with a big CANCELED and handing it back to the patient. Maybe its the look on the patients face when they come in wanting to see if its ready and I tell them they need to call the office at once.
Well this pile-o-crap burned two bridges that day, because both doctors cut her off. Of course she called Dr A from the pharmacy, and gave some sob story on how she lost her medication, blah blah blah, boo hoo boo hoo. Needless to say this Doctor has heard all of this before from every other crackhead around and I believe gave her the flying boot to the ass..
The world is a bit safer now because of me. Asshats.
The second notch on my narc-patrol bedpost came from a dildo who handed me an Rx from a Dentist in town that looked like this:
Vicodin 10. #90. 1-2t q4-6 prn.
Now why would a general dentist (not even an oral surgeon) be giving #90? Oh right, because the greedy fucker snagged the doctors pad and wrote it himself! Thats why!
Quick call to the doctors office gave me the “oh fuck no, thats a phony” response, upon which we told the asshat that the police were on their way, and that they would give him a free ride downtown. Needless to say he gracefully walked out of the store and into a car with new-car licence plates.
Why do people who scam the system always get caught because of greed? If its not #90 vicodin from a dentist, its 10 refills from the ER, or Oxycontin on a regular Rx pad. I swear, if they would just stick to smaller quanities that are believeable, and take the phonies for #20 vicodin to every pharmacy in town (while paying cash) they would have been scott free. You would think they would wise up, but I guess a good phony is one that’s never caught.
I always wonder if any pharmacists turn to the dark side and just start writing out or calling in phonies. They know the lingo, they know the red flags, they would commit the perfect crime. Of course any pharmacist after narcs would just snag a bottle of Vicodin from the back room and do the same thing with 1/4th the effort.

Crystal Ball and crackheads

Happy easter everyone! Hopefully if you’re reading this from work you’re making time-and-a-half. To help you get through another day, heres something for you to think of.
We all have those “problem patients”. You know, the ones who know jack and shit about their whole life. They waltz into your pharmacy (usually in some Soma or Vicodin induced stupor), and ask your clerks if the prescription the doctor called in is ready (usually not even giving their name in the process).
When the clerks say no, they get all upset and pissy and demand to talk to you. The conversation goes something like this:
Patient: I need my prescription! The doctor was supposed to call it in!
RPh: Okay, what doctor was supposed to call it in?
Patient: I dunno
RPh: Was it a refill? What was it for?
Patient: I dunno
RPh: Was the doctor supposed to call it in today? Or yesterday?
Patient: I dunno
RPh: Do you have your Insurance Card?
Patient: No
RPh: Are you a fucking moron?
So the last line I made up, but you get the idea.
Whats wrong with these people? Are they fucking stupid? What basis do they have to be angry with us that their prescription (which they have no idea what it is, but 99% of the time its for either Vicodin, Valium, Soma, or Tyl #3) isnt ready?
These same idiodic douchebags are the same type who always feed us the line “Well my doctor said I could pick up my pain pills today”. But of course you stupid crack whore! Let me take your word for it and refill your vicodin prescription 10 days early because YOU said the doctor said it was okay!! How stupid do they think we are?
Of course a quick call to the doctors office returns a “Oh hell no, we told her she could get them in 10 days!”
Lying hoebags. They always forget everything except when their dope needs to be refilled. I’ve never seen such compliance with any drugs than I do with Pain pills or Soma.

Mail Order Pharmacies: shove that stamp up your ass.

Apologies to any pharmacist that I may insult with this post. Ah what the hell, you deserve it.
Working in retail, mail order pharmacies really piss me off. I mean its not enough that us poor retail people get the “3 months for 1 copay” bullshit rubbed in our faces by our patients, but when you jerkoffs lose the prescription in the mail (or its late), who has to cover your ass when the patient is out of medication? Its the retail guys thats who!
You asshole chumps get special “mail order pharmacy” pricing on Rx medication, and super low pricing on shit like test strips and other diabetic supplies, but expect us retail folk to explain to the patient how to use their new shiny blood glucose machine for free.
You know what, eat shit! Shove that stamp up your ass!
I have half a mind to tell patients when they come in with your empty vials pleading for a few days supply of medication because their has not come in yet to go piss up a rope. Im not here to cover your mail-order ass. When a ignorant 80 year old comes in with that shiny new One Touch SuperElite Deluxe Model with 10000 buttons asking how to use it, I feel like telling them to go pay your asses a visit in your dark warehouses with fancy security doors.
I’m not here to pick up the pieces after you (or your patients) drop the ball and end up out of medications. I’m not your bitch when you’re getting 150 bucks for that 29 dollar glucose machine from MediCare and dont have to deal with the patient coming in 5 times becuase they cant match the code on the bottle with the code on the machine.
So the mantra for the mail-order pharmacy should be “do a half-ass piss-poor job because the retails chumps will cover your ass”. Reminds me of government workers.

Prenatal Vitamins & Bat Shit Crazyness

There is one prescription that I know makes every pharmacist get a little bout of acid reflux in their lives:
An Rx for some new funky-sounding prenatal vitamin with the big DAW-1 box checked. You know their insurance company isnt going to pay for it. Plus if they do, the’ll only cover a month supply so you’ll be stuck with the other 70 tablets making your prenatal section look like the warfarin /levoxyl sections (tons of bottles, all different strengths/colors).
Are OB-Gyn’s retarded? Does sticking your fingers into vaginas for a living rot your brain? Do they realize that there is NO significant difference between the bazillion of prenatal vitamins out there, and the drug companies are just exploiting pregant womens drive to have a healthy baby? With the exception of Folic Acid, there is really no research showing that one brand of prenatal vitamin is better than any other one. Its such an inexact science (since women can take nothing and 99.9% of the time have a healthy baby) that it boarderlines voodoo!
However to the uninformed: most prenatal vitamins have one of the following that make them “special”.

  • 1 mg of folic acid vs the 220mcg (or something) that the OTC ones have (folic acid has been shown to prevent spinal defects, so this one has some merit)
  • Some voodoo magical iron prep thats supposed to be gentle on the stomach of the pregnant woman who spends all day consuming dirt, pickles, and other wierd ass cravings.
  • Little hearts on the pills that make you feel all squishy as you pay $4/tablet
  • A bullshit name
  • 10000000% of your daily allowance of the B+C vitamins, knowing full well your body will just pee out 99.999% of it
  • 3.457mg difference in every other ingrediant thats present in all prenatal vitamins
    One woman claimed that she tried out 20 different brands of prenatal vitamins before she found one that “worked”. Now what the fuck is that supposed to mean? They all have the same shit in them! How can a prenatal vitamin “work” and more importantly, how can you tell its “working?” Does the fetus say “Yup, i feel it working better! Thanks mom! *thumbs up*”.
    Now dont make a mistake and bring up logic and reasoning in front of the poor pregnant gal. She’ll give you both barrels of hormone induced insanity all over your front counter in front of your entire staff (because its HER body and she knows exactly what the baby needs). Heaven forbid you’re a male, because you “dont know how it feels to be pregnant and taking inferior prenatal vitamins”. Reasoning with a pregnant woman is like reasoning with a turd, it just makes you feel stupid for wasting the time. Bad turd!
    OB-Gyn’s are partially to blame. The’ll write for whatever hot blonde walks in the front door with a low cut blouse and a bag full of samples. I can just see their fingers twiching wanting to give her a pelvic exam. They have been so brainwashed that they dont realize that an Rx for Folic Acid 1mg plus a super econo-size barrel of cheap generic centrum will do the exact same thing than StuartNatal.
    Just thinking about it gives me heartburn, must be those generic prenatal vitamins I take. 🙂

  • AARP, screwing seniors since 1958

    Today AARP was a bad bad boy!
    It turns out that due to a computer glitch between AARP/WHI/Argus, a ton of AARP Medicare part D patients got “disenrolled” or some crap like that.
    Meaning that a shit-ton of our patients had to call AARP to get their coverage reinstated. Of course is there any notice on AARP’s website? Nope. Surprised? I’m not! Took only 3 calls to AARP/Argus to determine what the problem was.
    Again, pharmacists are taken to the front of the battle lines to explain to the ignorant unwashed elderly masses why their cards didnt work, and they need to call AARP to get their cards reactivated. This is all the while AARP execs and staff are hiding behind their call centers collecting “record high profits” like every PBM has for the last few years.
    Shame on your AARP! Should rename you to the American Association of Retarded People.

    iPledge, the stupidest thing to come since Celgene’s STEPS!

    This last week I got my first experience with that new iPledge program.
    Let me backtrack.
    iPledge is this new system that came out to manage the dispensing of Accutane. You know, the anti-acne medication that if you take it while pregnant causes huge birth defects. So to make themselves feel better at night, they created this stupid program that basically accounts for every accutane prescription thats written. The outcome is that whenever I get an accutane Rx, I need to call the iPledge program (or go online via their broken ass website) to tell them what patent im giving the drug to, how much, and for what days supply.
    I know this whole bullshit is for liability reasons. Dispite the fact that every damn pill has a big DO NOT GET PREGNANT on it, and tons of warnings all over the packaging, somehow people are stupid enough to get pregnant while on Accutane. To them, I say “tough shit, you’re a dumbass. If you sue because of your fucked up baby, its your own fucking fault”.
    Are we next going to be putting “DO NOT DRINK” stickers all over bleach? Are people sueing Clorox because their daughter drank bleach? What about alcohol? Tons of children are fucked up because of alcohol use while pregnant, but you dont see tons of DO NOT GET PREGNANT stickers all over bottles of King Cobra nor a mandatory reporting everytime a store sells booze!
    The iPledge program is stupid. Very stupid. In fact, my first Rx dispensed with iPledge resulted in me calling their asses 4 times and the patient twice to get everything settled. I asked the poor girl who worked there if pharmacists were pissed off at the hoops we had to jump through, and they said “Well, sorta.” No fucking shit! Come on people! Personal accountability! If you decide to get pregnant while on this, even though it says DO NOT GET PREGNANT with little crossed out pregnant woman pictures /everywhere/ then its your own fucking fault! Get it? Your own fucking fault! No suing! No bullshit! Close your fucking legs and take responsiblity for your own mistake!!! The fact that they had to make this program to cover their own asses just shows you how pittiful and sue-happy our country has began. Its always someone elses fault!
    Wake up America! The high prices for medication are because of stupid people taking Rx medication (much like driving a car, has implied risks) and sueing the drug company over something thats totally out of their control! Furthermore, the greedy cock-sucking lawyers who take these cases should be publically hung by their scroatum for contributing to the problem!
    Hypothetically speaking, I dont have the balls to do this (yet):
    What if I dont call you. In fact, what if I completely blow your whole program off and just dispense the drug anyways? You cant stop me from getting the medication because unlike Celgene (with Thalomid) you are NOT the manufacturer and I do not order the product directly from you. Furthermore, you think my wholesaler is going to cut me off from this product when there are 10 different generic accutane manufacturers out there? I dont think so. Are you going to cut off my wholesaler when there are pharmacies that use the same wholesaler that are stupid enough to use the iPledge program? Are you going to sue me for something? Call the state board on me? Lets face it, you cant do jack and/or shit to me nor prevent me from dispensing this product. A quick call to the doctors office to confirm that the FEMALE patient is on birth control totally bypasses your whole program and legally absolves me from any liability. Of course i’m a good pharmacist and wouldnt do /anything/ like that to such a horribly designed program with a horribly designed website (https://www.ipledgeprogram.com/).
    Plus, to poke more holes in your already shitty program, how is this program going to prevent Betty Sue RottenCrotch from giving her slutty friends accutane under the table? Is iPledge going to detect that and magically send out the cooch-patrol to slam her legs shut? Lets face it, iPledge is just verbal masterbation that looks good on paper but really does nothing but waste mine and the doctors time.

    Argus, the $1.50 hooker of the pharmacy processor industry.

    Heres a simple question.
    Take a company, say, Argus heath systems. A huge company that processes Rx’s for such big names as Humana, Health Net, Blue Shield. You would expect a company of this size to have their shit together when the first rolled around.
    Nope. Guess again.
    Not only was Argus’ servers down for the whole day, but when you could process an Rx through you would sometimes get rejections for a completely different patient than whom you transmitted for! Talk about frustrating.
    Lets write them a letter.
    Dear Argus,
    if you are reading this fix your shit. Myself and every other pharmacist is tired of covering your ass when your servers take a dump. Spend the extra 100k on some decent hardware and some people who know what the fuck they are doing so you can provide a service that the people who PAY your bills (Health Net, Humana, etc) would be proud of. As it is now, if I were a PBM you would be the LAST person on my list to do my Rx processing. In fact, I’m going to be writing letters to all of your customers telling them how much you suck, and how they should go to CareMark or any other Rx processor who has their shit together. I dont care how big your load is, I dont care how many Rx’s you do a day. If you cant handle the load, then terminate half of your clients so you can do a GOOD job with the few you have remaining. You make more money per year than I make in my lifetime, and for that you should provide a stable service even on the first of the month.
    This is 100% true, so dont try any funny business with any slander/libel threats. You know your shit was broken today, you said it on your overloaded phone line recordings. Now be a man, admit you suck, and apologize to everyone who spent an extra $100 in retransmission switch fees because of your fuckups.
    Love and Kisses,
    The Angry Pharmacist.
    PS: You better send Health Net a fruit basket, because their managers and staff are not happy with your preformance, and I sure as shit made that known to everyone whom uses you for Rx processing. You give them all a bad bad image. Shame on you! Bad Processor! No cookie!