The time for candy coating it is over….

I’m tired of candy coating and being all “politically correct” about this issue, so I’m just going to come right out and be an asshole. You’ve been warned:
Do you know how fucking frustrating it is to have to have a ‘nurse’ repeat him/herself about 20 times because it all sounds the fucking same?
Now I’m not saying that you aren’t smart, or capable, or a bad person. I’m making a statement of fact that when lives are on the line, pharmacists need someone who can speak clear English when calling in medications. I’m tired of this happy-go-lucky huggy embrace everyone society that we have now that just looks the other way when some un-educated foreign drone calls in 20 Rx’s that all sounds like vowels on my answering machine. I’m sorry, but stop it. Get someone who can speak English to make that call. Me calling you back to “confirm” is not only a waste of both of our times, but 100% unnecessary if it was done correctly and clearly in the first place.
You think I’m being an insensitive racist asshole. You’re right, I care about my patients, and my state license/livelihood/my patients life is riding on your piss-poor language skills coupled with a ‘degree’ from a 3 month community college program. I’m sorry if I hurt your feelings, welcome to the world of medicine. I’m sorry if you cant help your accent; doesn’t mean you need to change jobs, just don’t call in Rx’s. They don’t let retards fly fighter jets and you don’t see them getting butthurt by this.
So pony up and accept it. Drugs sound the same. Obviously you don’t know this because you are still calling in Hydr-vowel-vowel-bok-bok-bok and require an interrogation session for me to determine if you mean HydrALAzine vs HydrOXYzine, TopROL vs TopaMAX, BID vs TID, etc etc etc.
This doesn’t stop at nurses, oh no. Pharmacists and Doctors are just as bad. If I request you to fax over that copy, and you are “too busy” and want to give a verbal, I’m just going to come right out and say that I want it faxed because I can’t understand what the fuck you are saying. I pressed “1” for English bitch!
So yeah, I’m an asshole. However I’m an asshole not because I hate you, or your race, or where you came from. I’m an asshole because you don’t seem to get the very clear and very important concept that you lack a very vital language skill that puts not only my patients life on the line but my license and store as well. Medicine requires clarity or people get hurt, you should of learned that in school. Sorry for fucking caring for the whole at the expense of insulting a few.
Oh, you know when I said I was sorry up there? I lied. I’m not sorry. I shouldn’t be sorry for standing up for patient safety when nobody else seems to have the balls to confront this issue (and make people upset? Oh no!).

How do you price your drugs?

I have a legit question. You may comment anonymously, use a fake email and name, however you wish. I’m not going to go running off taddling on you all for answering this question, I am legitly curious.
How do you price your medication? I’m just curious how the chains do it vs the independents. Do you take like “AWP + Dispensing Fee + %age?” Or “Direct Cost + Disp Fee + %age?”
It seems like the price of generics fluxuate between pharmacies to bargan basement (independants) and ass-rapeage (Walgreens/Rite-Aid). Do the chains just accept pricing from the corp office or do they have some say (such if a patient has like $10 for atenolol, and the price is like $11.50, can you lower the price?)

WHI Downtime – Walgreens again screws over everyone.

Turns out that Walgreens Health Initative ( not Walgreens the Retail Outlet. Same Bat-Time, different Bat-Channel) decided to do a “system upgrade” on a Monday that resulted in downtime all of Monday and Tuesday.
Gee. You would think that with their bazillions of dollars they are making (since they pay us retail folk jack-and-shit) they wouldn’t be down for a whole 2 days. Furthermore, you would expect that they would do a “systems upgrade” at like 2am on saturday morning when all sane pharmacies are closed.
But no, I had to deal with a huge stack of claims that needed to be billed today because WHI screwed the pooch and decided to take themselves out of pharmacy gene pool for a whole 2 days.
Sorry this isn’t very angry’ish. However I will leave you with a bit of fun information. Take your usual Gin and Tonic. Now instead of drinking it right away, put a slice of cucumber in it. Now sip and taste the wonderfulness. Some chap from Australia dropped me that note, its magical.

TAP – 2 / Drug Reps – 0

I swear, sometimes this website just writes itself. I wrote this a while ago, but you guys have already picked out all the choice material in the comments by the time i got around to post it. 🙁

I have been in medical sales for my entire career, ten of those as a drug rep. I am a professional woman, I dress professionally, and hopefully I bring decent information to the doctors and pharmacists that I call on.

“Decent” information would include unbiased information.. So you bring propaganda, because you have a desired outcome the moment you walk in the front door..

Drug reps are not prostitutes, nor have I ever “sucked anyone’s….” to get business. I have never been out on a date with a doctor. I seperate business from my personal life.

Oh jeezus. Wear a net over your head so maybe you’ll understand one of my many jokes.
Did you really think that I thought drug reps were out giving doctors blowjobs and lapdances? Seriously, it was a metaphor, a figure of speech to mean that they were selling themselves and preforming “favors” in the way of pens and free dinner/goodies in return for something, in this case writing for the product that you are pushing. It was a creative and descriptive way to say “bribe” or “kickback”. Its not really prostitution, because the doctors aren’t paying YOU for your services, its the other way around, so its like reverse prostitution, prostitution^-1, or noitutitsorp (thats prostitution backwards).
Now if my made-up example was correct, and there were drug reps out giving blowjobs in return for writing for their product, then I’m in the wrong damn profession. 😉

Two things are going on here and I know that you are just going to slam me but I will say it anyway. Normally I find your blog funny, as I do have a sense of humor. I too think that the industry as a whole needs some repair.

True, and I’m glad you have a sense of humor. I do too, and if you think I treat drug reps in my store like I rag on them on here you are mistaken. I dont care what they have to say, but i’ve never crumpled up a business card and thrown it at them screaming. I just smile and nod as I’m up to my neck in Rx’s and answering the phone. As they are reciting their little speech about how wonderful the next $400 wonder drug is, I say “oh really?” and an occational “uh huh, wow!”. But to be honest I dont really have time to sit there and grill them.

But maybe, just maybe, you have interviewed for a position as a drug rep, and you just don’t cut it? So you are disgruntled? There is alot more to being a rep than throwing out pens, ect. I will put my knowledge of the 4 drugs that I sell up against any MD or Pharm any day of the week.

Oh, yeah… I couldn’t make it as a drug rep so I decided to be a pharmacist instead. You know, because I am incapable of knowing 4 drugs yet somehow capable of knowing all of the major classes, the disease states, the mechanism of action, and everything else that goes into being a pharmacist. Head, meet desk.
You can put your knowledge of the whole 4 drugs you know against my knowledge of not only those same drugs, but the treatment plans for what they treat, their mechanism of action, what patient population you can and cannot use (based upon how its cleared), AND who covers them.
Dont compare your knowledge of 4 whole drugs against an MD and think you’re some hot-shit or something. Anyone can walk circles around them in pharmacotherapy-land much like MD’s can run circles around me quoting excerpts from ‘Harrisons’ and diagnosing Wierdo-McButtfuck-Syndrome. So I’ll say this: Maybe YOU tried to become a pharmacist and couldnt cut it so became a drug rep instead.

You and the docs have to somewhat know the PDR

That quote right there just completely blew your whole argument right out of the water. The PDR is shit. Any pharmacist who uses the PDR needs to be publicly drug out into the parking lot and shot. Pharmacists use books that manufacturers dont PAY MONEY to have put in there. We use Facts & Comparisons, Lexicomp, or any other REAL pharmacy reference (Remingtons for the hard core old timers out there! Go big green book!). We pay big dollars for our reference books. We also use pubmed to get journal articles (you know, those pieces of paper you give to doctors in the nice binders printed on glossy paper with the big words and weird looking graphs on them). Pharmacists use unbiased sources and draw their own conclusions using the available data, its what doctors should be doing as well.

, we have to know our products.

You dont know your product, you recite what the mothership has brainwashed you with. Did you take pharmacology? No. Did you go to college to learn about therapeutics and treatment standards? No. You got the pharmacy cliff-note version of “here is what you need to know”. Memorizing numbers and figures and fancy acronyms for studies that spell out things like SHIELD and stuff.

Or maybe, you are a fat,ugly nerdy type with no personality, and a good looking woman ( drug rep or not ) will not give you the time of day?

Well you are a poo-poo-head dummy butthole. I’m taking my wagon and going home because you called me names!
Actually I (and im sure most of the people on here) wish that no drug rep would give us the time of day. And how can you say with a straight face that I have no personality! Look at what I write on here! I have talent!

Because your anger towards women in general comes out loudly.

Because every comment about drug-reps I make involves women? Hate to tell you, but most MD’s that actually listen to your bullshit are men. Plain and simple. For some reason the women doctors around here dont really care what you have to say and I get far less DAW-1’s and your silly drug-rep stamps from the women then I do from the men. Plus most if not all of the female drug reps (and I see a ton of them) are really hot. I can talk about the male drug reps giving.. uh.. lapdances? to the female doctors? yeeaah.. with his low cut pants?… uhhh.. suuuuure…. doesnt really have the same effect, sorry.
But you’re right. I hate women. I’m only engaged to one, and work with a whole staff of them for 9 hours a day. Does it count if I beat them with my belt? What if I make them worship me and call me “Your royal angryness” (that sorta has a nice ring to it)… “A new Rx on line 3 your royal angryness!”… “Yes your royal angryness, I shall get you the tramadol 50 and count thee 60 of them”… “Your royal angryness, there is a woman here who says her vico-dans were flush down the privy. What shall we do with her sir?”…
Give me a break, seriously.

Normally I laugh at your blog, but your anger has taken a dark turn towards people who are just like you, trying to make a living in an increasingly difficult world run by insurance companies.

Ever think that maybe the company you work for is part of the problem and not the solution? Wonder why insurance is so damn high now days? You think the insurance companies like your little speeches to change everyone from a product that costs them $5 to one that costs them $200? I realize you are making a living selling something, but its just that, selling something. You are a salesmen, not a consultant but a salesman. Quit acting like you are a consultant to a doctor/pharmacist (or part of the treatment “Team”) and start acting like the commercials I see on TV.

And one more thing, as you rail against people and their habits or addictions. Alcohol is an addiction too…you just are able to buy it in any when you talk about your drinking in relation to the people that you despise with addictions to rx-meds, perhaps you need to look in the mirror?

If I give a liquor store owner both barrels because I drank my whole bottle of scotch in 3 days when it was supposed to last a month even though the directions say “1 glass at bedtime” then yeah, I expect to be bitched about. I don’t rail on them for being addicts, I rail on them for being so dense and oblivious to the stupidity they inflict upon the world then giving me both barrels thinking its all MY fault. Am I out selling my booze that I got for FREE on the state dime? Do I lie and make up stories to the liquor store man so I can buy another bottle?

Later TAP.

Thats TAP(tm) (I know the angriest is watching). Are you really a drug rep? Or is someone playing a joke on me. Seriously, for someone who has been a drug rep for “10 years” i expected something a bit more.. uh.. realistic?

Woah. I cant believe it.

I am one of those drug reps that you hate see walking through the door but
I have to ask a serious question. Do you think that generic Coreg is
equivalent in efficacy/tolerability to the branded Coreg? Also, since there
will be 14 potential manufacturers of generic Coreg, will they all have the
same effect? Hasn’t there been alot of difference with the generics for
metformin? Maybe not? I would like serious responses because if generic
Coreg is as good as the branded then that will be great for your customers.
They will be getting the best beta blocker at an affordable price. How
about the patients that switch from branded Coreg or Coreg CR to the
generic? Do you see any problems in regard to potential decompensation of
their CHF? I know post MI and HTN patients will be different but the CHF
patient is a little more vulnerable. Also, how about the patient who has
the same co-pay or a little higher for branded or generic- would you
recommend that they switch to generic? This personally happened to me when
I got a script filled. I have the same co-pay and I was given a generic
without being asked. Wasn’t happy about it so asked for the branded that
the doctor wrote on the script.
Thanks for your serious reply.

I love it when drug reps use big words! Its so cute! But seriously, I dont understand how you can believe the stuff that GSK pounds into your brain and you extrude out of your mouth.

  • Tablet making isn’t rocket science. For the “variability” that you talk about, how do you know that the same “variability” isn’t present in the trade name? There isn’t some magical formula that the trade name company in making the tablets, and there isn’t some special machine that GSK has that proves equivalency between invidiual tablets that huge generic manufacturers (Mylan, QT, Watson, Dr Reddy) doesn’t already own. Their ass and reputation rides on their product much like GSK does. So yes, the tolerability and safety will be equivalent. Yes, generic Coreg is great for our patients HOWEVER your employer wants you to switch everyone over to their product so they continue to make a 5.8 zillion dollar profit and screw everyone over. Its business, plain and simple. If Coreg-CR was a superior product from the get-go, then they would of came out with Coreg-CR initally and not the IR. Amazing how GSK did the exact same route that Ambien and Paxil did; release an CR product when (gasp) their product just happened to go off of patent. I bet any money that Avandia-CR is in the works right now. You should of went the Clarinex/Lexapro route and purified an isomer to make doctors cream their panties when they hear about this ‘new discovery’.
  • You know what I’ve found with generic metformin? The patient eating birthday cake the night before he switched. Taking the new brand on an empty stomach vs always taking the old brand on a full stomach. I “don’t like the color” or “This one has the bad smell”. Yeah, totally irrelevant psychosomatic or outside variables that no drug company can compensate for.
  • With decompensation with CHF patient, if they are being treated correctly (meaning a Beta-Blocker, an ACE-I cranked up until cough then reduce by ~10%, Aldactone, lasix/K+) then they shouldn’t have any decompensation problems one bit. Of course Doctors dont want to put their patients on the “proper” CHF regime because its a lot of pills, so they just give them Coreg and some lasix and send them on their way (then wonder why they end up in the hospital).
  • If patients have the same copay between trade and generic (which they don’t), i’ll still fill the generic. Why? Because I dont want a $200 bottle sitting on my shelf when a $5 will do when there is no significant difference between the two. I’m on medication, my boss is on medication, and some of our staff are on medication. They are all generic (and we stock the trade name). Why? Because its cost-effective for the store, for us, and for our insurance companies. We do “the right thing(tm)” of our own free choice. I hate people who are so brainwashed that their doctors are some sort of deities and demand they get trade name Amoxicillin because their doctor wrote it on the prescription.
    So, its time to ask you a few questions:

  • Take like Toprol-XL, Lotrel (Sandoz Brand), Zocor (when it /first/ came out), etc. Know what all of these have in common? Their generics are made by the trade name company. Do you still whine and push your “not equivalent” propaganda when the Sandoz brand of generic Lotrel look exactly the same as trade name Lotrel? I know that GSK probably doesn’t do this yet, but when they do, will you still be pushing some new-product-x and bashing the generic when you fully know that the generic is made by YOUR company?
  • Seriously, how many free trips/dinner/fancy pens/lapdances/kickbacks/bribes/”incentives”/”rebates” do you bring to cardiologists to push your new drug? Do you just throw a bunch of studies in front of him, recite some numbers from a study that GSK funded showing (surprise) Coreg CR superior to God himself and throw schwag at him? Don’t you watch those infomercials on TV and wonder that maybe you are a real-life one? Don’t you believe that to practice “good medicine” the doctor needs to have a un-influenced (meaning no goodies) decision on what agent would be the best and safest for the patient found out on his own free will? If a doctor is “too busy” talk with ME, a licensed professional about his patients health and medication then why would he have enough time to talk with YOU unless you somehow benefit him with free goodies.
  • Do you tell him how expensive this shit is? I mean “I have this wonderful drug that will cure everything” sounds great, until you say “but it costs 34 kerjillion dollars a month”. Seriously, what doctor is going to prescribe something to a patient knowing full well they cant afford it? Oh, because you don’t tell them how much it costs. So I get on the phone, and I tell him “Uh, Mrs Smith has no insurance, and new-drug-x costs $200/month”. He/She goes “Oh, I had no idea, the detail person was just in here”. See that? By you omitting information, you just cost both of us time we did not need to waste.
    So I want you to do something. I want you to take a few hundred bucks, and throw it away every month for no reason. Then you’ll see what its like to have no insurance and have your Doctor refuse to switch from Coreg-CR because of someone like you.
    Told ya I didn’t like drug reps. Im sure you’ll get some colorful comments from other pharmacists who share my view.

  • GSK – 1 / TAP – 0 and what patients will do for their pain pills

    Lets just say that I love generic Coreg. Seriously, just absolutely love it. If I could have sex with the bottle I would. Why?

  • Its a generic that right when it hit the market was affordable. None of this $20 less than trade name crap. I’m talking bargain-basement cheaper than vicodin. I bought a years supply of it because what is the price going to do? Drop to free? Plus I hate switching generic manufacturers on people.
  • Its a godsend to Medicare part D patients in keeping them out of the Coverage Gap. Seriously, I had a little old lady in her coverage gap almost do cartwheels when she found out that a month supply of her Coreg wasn’t the usual 150-200 bucks, but a whopping $9.95.
    However my glee was immediately kicked square in the nuts by one doctor in town. We have a patient who has been on Coreg since it came out. He has MediCare part D, and fortunately he is not on many other things so I believe he is just now getting into the coverage gap. Now Coreg-CR has been out for 3 months or so. The patient has been on Coreg all this time. I send the refill request all gleefully waiting to fill it with shiny new generic, and guess what comes back:
    Coreg-CR 20mg 1 cap qd #30 DAW-1
    I hate drug reps. I really do hate drug reps. Now you know why. If the Dr though that Coreg CR was a superior product, why did he happen to wait until a week after the generic comes out to switch him? Why wasn’t he switched over while Coreg was still trade name (and during the three months Coreg-CR was out)? I guess Coreg just suddenly became an inferior product once the magical patent wore off (when it was perfectly fine for him for years). Maybe I should ask the blonde GSK rep that is sucking his cock if she had anything to do with it. Seriously, now he is going to be in the coverage gap for sure, and up shit creek without a paddle. Thank you Dr for totally financially fucking over my patient because of some talking pair of tits who obviously has more intelligence than you do. Ironically my boss and I were talking about throwing away all of those Coreg-CR DAW-1 forms about 5 min prior.
    Pisses me off to no end how some doctors who view themselves as so intelligent can be so absolutely fucking retarded. When will they actually think for themselves and stop listening to real-life paid advertisements? I think the drug-reps should have prescriptive authority, obviously they must know more then this doctor. And to think I defended Avandia in the past! That cheating whore!
    On a happier note, we’ve had doctors who just now find out that Coreg went generic (probably because the GSK reps have been out in full force), call me and ask how much it is (for which I say “basically free”) and it makes their day. Now good doctors (meaning ones that have free thought) are going just as crazy over this as I am since now their patents get a good product for an affordable price (like it should be). Plus it makes the patient happy, me happy (I don’t want that expensive trade name shit sitting on my shelves), and the doctor look like a hero. Win-Win-Win situation. Every pharmacist loves to tell patients that their once-expensive drug is now cheap-as-dirt, and to be honest I give full credit to the doctor if the patient asks. Do I get thanks for this? Yeah, I do, and it makes my job worth the shit I write about on here.
    Onward with the second part of this entry, what patients will do for their pain pills.
    Do patients think that us pharmacists don’t talk with each other? I mean seriously. I know pretty much every pharmacist in my town (or at least in my area) and if they don’t know me personally, they know my boss personally (who has been in the area for 30 years. Before Walgreens came and overtook all the Independents). I mean you see them at the pharmacy association meetings, you go drinking with them, you ask them what person code to put in new-insurance-x, you call them looking to see if they have a broken bottle of Meridia (ugh, hate) they want to offload, etc. For the students out there, the pharmacy world is extremely small. When the medicare part D shit hit the fan, we would all band together (even the chains) to help each other out. I may rag on the chains, but when the shit hits the fan we all pull together for each other. In the meantime we rag and play jokes on each other. Good times.
    But I digress in my 2-martini to the wind state.
    We had a patient who wanted his pain pills refilled 2 weeks early (gee, surprise). The doctor flat out told us to tell him to go fuck himself, he had a contract for 1 refill a month regardless if God himself came down and took them (that would be an excuse I hadn’t heard before). He asked if he could use the phone, which of course I let him. He called a fucking pharmacy down the road (another independent no less) to see if he could get his pain pills refilled there! I just sat there and shook my head in total disbelief at this guy. So of course 30 seconds after he hung up I got a phone call from that pharmacy. We sat there and chatted a bit about how things were going, and if they were busy, and how this guy had the balls to call him using our phone. Then I told him he wanted his narc’s 2 weeks early and he had a contract. Talk about pooping in the poor crackheads punchbowl. Needless to say he left a very sad panda, and I had something else to write on here other than how much I hate drug reps.

  • Pharmacist Hate mail!

    Ah, I love it when I get hate mail from other pharmacists. After reading this over, I mostly agree with him/her (surprisingly). Though I dont think CVS wants this persons name attached to what he/she wrote.

    1) You don’t have the staff to handle the load from mail order pharmacies
    if they disappeared tomorrow.

    You meaning me personally? No, you have me there god dammit. If every mail order place closed and they all came to /my/ store, then I guess I’d be up shit creek without a paddle. So would you. Thats sorta like saying “If someone drove a car through your front room, you’d be upset”. Pretty much a big “Duh” there.

    2) I get one of my meds via mail-order, because I got tired of paying 3
    copays when I could do 1 instead. I’m not an idiot for doing this.

    Then don’t bitch when your patients jump ship and do it to you. Of course I see that you take gifts from drug-reps, so that says something. At least you had the common sense to throw out the DAW-1 forms when the Coreg vultures came circling pushing Coreg ER. I did the same thing too, but I didn’t get any loot from them. Actually I told them they were a bunch of liars for pushing Coreg just months before, but suddenly going against all they told me once the generic came out for $5 per 100. Amazing how all those studies just aren’t worth dick if the drug company that paid for them isn’t making a $100+ profit from each Rx that I fill. Thank you Mylan for making generic Coreg so inexpensive.
    Working in a pharmacy Im surprised you even have to pay copays for your medication. Even I dont have to pay the $25 copay on my medication. 🙂

    3) You bitch and moan about “kickbacks”. Sounds to me like you’re a whiney
    independent pharmacist pissed off because you don’t have the economies of
    scale that a mail order house does. (And neither do the big chains,
    incidentally.) Since you’re throwing out some pretty serious accusations,
    you should offer some sort of proof. But since you’re full of shit on this
    particular point, you can’t. Go ahead, though, I’ll wait to see what you
    come up with.

  • Why do insurance companies mandate their patients go to a mail order pharmacy? Say, like Express Scripts. The ones that don’t mandate it by flat out rejecting the claim penalize the patient by a higher copay. Doesn’t that sound wrong? If they gave a choice as to which retail outlets is one thing, but to mandate they go to their mail order pharmacy exclusively sounds like a huge conflict of interest. I mean that would be like saying that WHI (Walgreens Health Initative) can only get their Rx’s filled at Walgreens. Or that Blue Cross patients could only go to one doctor (and no other doctors could see these patients). Explain to me how Express Scripts can actually get away by forcing their patients to use their outfit even though they wish to go to me or you to get actual “service”.
  • Why can’t retail outfits buy “Mail Order Only” diabetic test strips (say by AccuChek) at a discounted price? What’s so special about these ‘Mail Order Only’ strips and why are they cheaper for Mail Order than regular retail stores? Why brand them differently? If bulk is the answer, then whats the point of re branding them vs just selling them at a lower price to the mail order outlets like all the other medications? Why is it illegal for Retail outlets to even carry Mail Order branded strips?
  • You can call it rebates/kickbacks/bribes whatever, the fact of the matter is that Mail Order Pharmacies get special treatment that retail outlets don’t. You would think that Walgreens/RiteAid/CVS (ahem) would get some sort of pricing break since they obviously dispense more Rx’s/day combined than the mail order outlets.
    Read the comments of the people who get screwed due to “mandatory mail order”.

    Yeah yeah insurance companies are the devil, I won’t argue with you there.
    You’re not stupid, you knew that before getting into this business.

    By the email you sent me you assume that I am. Insurance companies didn’t use to be like this, you and I both know this. Its spiraled out of control.

    4) I called Walgreens last week for a transfer, and I got some kid with a
    fucking stuttering problem. “W-w-w-waaaa m-m-m-may I [something]?”
    “Uh, what?”
    Repeats himself.
    “Uh, what?”
    Repeats himself.
    “I have no idea what you’re saying to me. I need to speak to the
    “W-w-w-algreens m-m-may I h-help you?!”
    “Oh. That’s what you said. I need to speak to the pharmacist.” (Thinking
    “WTF” at this point because I had the pharmacy for 5 seconds before they
    put me on hold for ten minutes then this kid picks up the phone, and I’m
    thinking I got transferred to a psych hospital or something.)
    How in the fuck is this good customer service?

    Uh, did I say this is good customer service? Or is this just an aside from the whole bitch on how much i’m wrong. Whenever I get copies from Walgreens I just call the ‘Doctor Line’ and leave a message with what I want.

    “Ok, I am just a tech, but I am also a pre-pharm student, so when I read
    this I see my future going down the drain.”
    TAP is a drama queen. It’s what makes his writing compelling. It’s like
    dessert, a little is good, a lot is just sickening. You need more than just
    TAP if you want to get an accurate picture of the profession today. Enjoy
    it, but don’t read any more into it than one man’s thoughts. Always
    remember that someone has been prophesying doom and gloom for every
    profession on the goddamn planet since time began. Pharmacy included. You
    might want to diversify your reading a little bit, and read someone like
    Jim Plagakis instead of just TAP.
    If you hate retail pharmacy, it’s probably because you have/had a shitty
    And don’t ever say you’re “just” anything. Let your words speak for
    The impression I get is that TAP is also an independent pharmacy elitist.
    (After all, everyone else is “shitting on the little guy,” why not the big
    chains, too?) Most of the chain stores in my area are run far more
    effectively than the few independents around here, which leads me to
    believe it’s a local problem for him.
    You can still do a great job working for a big company, and you still deal
    with the same ground-level shit as anyone else behind the counter,
    independent or otherwise.

    Shitting on the little guy? When did I say the chains were shitting on the little guy (or even imply the idea)? I was making a joke that the Walgreens distro warehouses hires retarded folk and how that relates to me getting copies from their store. The retarded folk dont even work in the retail stores but the warehouses! The post you were responding to was regard to Mail-Order (which do shit on the retail folk) and really had nothing to do with the chains! Hell, I’d rather transfer the Rx to a chain that I know will actually /see/ the patient than some Mail Order place who will lose their medication.
    However from reading how you handled the Walgreen example above, I think you’re just a bitter unhappy pharmacist like the rest of us. Welcome to the club. All I hear from patients all day is how Walgreens take 2 hours to fill their Rx while the pharmacists just sit there and drink coffee as they offload the script-pro. Patient care has taken a back-seat to a quota that corporate imposes on the chains. I have worked in a chain, I’ve worked in a hospital, and I choose to call home in a small family owned store that does about 300 rx’s a day without any fancy phone answering machines or bazillion dollar counting machines. If someone stays on hold for more than 2 min’s I start to drop everything and answer it. My livelihood isn’t shielded by corporate offices and mega-funds, but the honest-to-god service that I dish out on a daily basis. If I give you totally shitty service, the store gets no patients and I don’t get paid. I don’t have a mega-corp guaranteeing that my paycheck will clear every 2 weeks. I think that says something vs the pharmacist who never talks to patients, just sits in the back and answers the phone, and has a bunch of barely trained clerk-typists pounding away on 1000 keyboards as the script-pro machine churns out drugs by the hundreds. That being said, I have seen the kind of service that I dish out in every chain on the planet. So don’t get your panties all up your crack thinking i’m ragging on your precious CVS.
    Some of the best pharmacists that I have ever met (and who have a huge following) used to own their own stores, and now work for some of the mega-chains because they don’t want to deal with the shit that running a business takes. One of the things you’ll learn in pharmacy is that the pharmacist makes or breaks the store. I’m sorry if I act like an elitist (and actually /care/ about people). I don’t shovel out Rx’s by the truckload, and actually will go out and explain medications to people that they got filled at a chain store (even CVS).
    On the comment about reading this site and seeing the downward spiral of pharmacy:
    Why would anyone with half a brain read a blog saying “The Angry Pharmacist” and expect anything other than the bitching and rants from the profession? Lets take the 0.02% of pharmacy that really pisses us all off, and judge the whole profession by it! If you work retail, and you hate retail, then something is wrong with either the place you work or you just happened to draw a really shitty staff. Even I don’t hate retail. By reading only this site you are looking at only a small portion of one side of the coin, and I’ve said it time and time again that you need to take what i say here (or what the DrugNazi says, or what the angriest pharmacist says thats what we say but changed a bit) with a grain of salt and not the gospel. You just gotta laugh, relate, and move on.
    I am not “prophesying doom and gloom”. I’m telling it how it is. Plain and simple. Colleges have banned my site from their school networks because of this. Of course pharmacy school students just love me, other pharmacists love me, and (some) doctors love me. It gives us all a common place to bitch, laugh, and relate to frustrations of a very stressful profession.

  • Mail Order Scum

    Now everyone knows that nobody is safe from The Angry Pharmacist(tm). I always wonder why I never get featured in Drug Topics or any other pharmacy magazine that pharmacists read while taking a dump. I guess I’m too hard core (or use bad words way too often) to be in any cool magazines. 🙁
    Oh, yeah, mail order pharmacies.
    Lets just say that I hate Mail Order Pharmacies. Plain and simple. If you work for a Mail Order pharmacy, seek a career as a prostitute or maybe a Drug Rep or something. My hatred is from a multitude of colorful points that every retail grunt knows:

  • Mail order places get kickbacks from the insurance companies. Yes, I said kickbacks (not rebates, but fucking bribes/kickbacks). Why cant retail pharmacies dispense a 3 month supply for 1 copay (without losing money, a la Walgreens Medicare part D). Why do mail order joints get special deals on “Mail Order Only” test strips and supplies? Why do mail order (and hospital) pharmacies get special price breaks on generics? Oh, kickbacks. Did I mention that some insurance companies will only allow 3 fills at a retail pharmacy before mandating the patient use their mail order pharmacy? How can you say thats not kickbacks. Seriously, get your head out of your ass and wake up and realize that Mail Order pharmacies and the insurance company’s asshole they screw every night are making not only us retail folk look like money-grabbing bastards (“how dare you charge me $5.00 copay/drug a month! I get $5 for 3 months from my local mail order pharmacy!”) but………….
  • They waste our time! How many of you retail folks have had a Mail Order patient come in with a sad-panda face and an empty mail order bottle saying “Uh, my mail order medication got ‘lost in the mail(tm)’. Can I have a few atenolol so I dont die?” The Angry Pharmacist(tm) in me wants to say “Fuck you! You said that I was ripping you off for charging you a copay every month (because their insurance company wont let us fill a 90d supply, only their mail orders get to do that) and now you come begging and groveling to me for medication because it got lost in the mail? HAHAHAHA DIE!” but the actual pharmacist in me doesn’t want to see more of the MediCare money (that i’ll never see) wasted on a pointless ER visit (see DrugNazi, I care). So I charge him a whopping dollar for like a week of atenolol and send him on his merry way to go fuck me behind my back with his Mail Order Pharmacy mistress.
  • Patient comes in (who you know goes mail order) with a brand new testing machine. They plop it on the counter and wish to know how to use it. They said “The mail order pharmacy said to just take it in to any retail pharmacy and they’ll show me how to use it”. Uh, go fuck yourself? Do I work for the mail order pharmacy? Is my employer going to be happy that his over $1/min pharmacist is out helping a patient (who will never trade with us) with his machine that another pharmacy made a fat profit on? Let me consult you on the medications that Walgreens filled for you while I’m at it. We all know those chain pukes are too busy to actually do anything than shovel Rx’s out the door and drink coffee, so let me do their jobs for them (for free!).
    While I’m ragging on “The Pharmacy America Trusts(tm)(r)(blah)”, did anyone read the article on how a Walgreens DC has over 40% of its employees have a “physical or cognitive disability”? Now I realize this is a distribution center and not an actual store, but have you ever tried to get a copy from a Walgreens? Have you ever tried to speak with one of their clerks? Yeah, I’ll just stop right there. As a sidenote guess how many of my Walgreen buddies got a fax when that article came out. 🙂 I’m so loved. Back to hating on Mail Order.

  • Doctors offices are even getting bribes from Mail Order joints. We have had more than one patient suddenly (and unknown to him/her) that all of his Rx’s were mysterously filled by a mail order pharmacy (we tried to fill them, and the insurance company gave the reject). A few phone calls later we found out that this Mail Order pharmacy that “partners with the doctor” magically got a full copy of all the meds this patient was on, and filled them without the patient even knowing what was going on. The pretense was that the medication was going to be “Waiting for the patient in the doctors office” so they “Didnt need a trip to the pharmacy”. Did I mention that said mail-order joint filled a 3 month supply when the insurance company put a 30 day restriction on retail? Amazing how fast the claims got reversed when the word “kickback” and “bribe” got thrown around between us and said Doctor/Mail Order Pharmacy.
    So what can us retail folk do about this? Complain to the insurance companies? No, they are in on it. Complain to the Doctor? They don’t care, not their problem. Complain to the State Board of Pharmacy? HA! The Mail Order place is in another state, good luck!
    Guess we bend over and take it. The problem is that unless we are total incompassionate dicks (not only a failure to our profession) and make folks go to the ER when their mail order shipment gets “lost”, they will never learn. Unfortunately I’ll be the first to admit that even I am not that much of an asshole. I have to ™ my shit or else the angriest pharmacist will steal it(tm). Heh.

  • 14 and pregnant – Warning! Offensive!

    This entry is going to piss off some people. You’ve been warned, this is ‘the angry pharmacist(tm)’ and we know that we cant be angry without painting people/society/your mom with an extremely large overbearing brush. I also had a few beers after a long and frustrating day at work, be warned, be very warned. The hatred is flowing like the DrugNazi’s scotch.
    You get an Rx for some prenatal vitamins. You pull up the patient by name and 14 year old comes up. You realize “shit, I must have the wrong person”. Then you realize that the 14 year old in front of you is indeed pregnant. The parents stand proudly by as happy as can be. As said before by the DrugNazi, “You turn the dials behind your eyes from stun to kill, but they just wont work” (or something to that extent).
    Some of you out there would feel sorry for this poor girl. Some of you would feel happy for this girl. I, for one, think that I’m filling an Rx for the stupidest human on the planet. Why feel sorry for her? Pregnancy isn’t some virus that swoops down like the flu and afflicts people without discrimination. It requires a conscious act between two individuals. Whats even more frustrating is that its not hard to get birth control these days! So the only reason why these kids are getting knocked up is due to laziness!
    If someone comes into my store and wants condoms, and says “yanno, do you have any free ones, I really cant afford them” I’d throw them a box right there on the spot. In fact, we have a stock of free condoms that anyone can take that are furnished to us via the county! You just have to ask! Girls (because they aren’t women, they are in fact girls, deal with it) can go to any clinic and get some free birth control. What provider is going to turn down a 14 year old who wants birth control because she is sexually active? One that obviously doesn’t have any foresight of whats going to happen. Even in the age of HIPAA/parental consent police/cover your ass/etc it doesn’t require an Rx or anything for girls to get condoms!
    People use the excuse that they are too shy or afraid to ask for these things, they don’t have the transportation to get these, they don’t have an education, they “don’t know better” (whatever the fuck that means), etc. Put that on the very top of the list titled “Not my fucking problem”. These kids should NOT be having sex if they aren’t prepared for the consequences. End of story, write that on my fucking tombstone.
    Some girls at 14 might decide that they want a baby. You know, to be a ‘grown up’. They may think they can ‘handle it’ or some bullshit like that. Way to rationalize a big fucking lie. No girl knows what they want at 14. In fact, having a kid at 14 pretty much screws over your chances of doing anything productive with your life. Actually, if you do something productive with your life after having a kid at 14, it means that you weren’t being a good parent and putting your child first!
    Lets not leave the guys out of this. They may use the “i’ll be there for you baby” lines, but when the shit hits the fan (or the girl gets incredibly fat during/after pregnancy) we know who’s on the next bus to the nice piece of ass that comes their way. I’d trust a vicodin addict to watch the store while I get some lunch over a 14 year old boy who says he’s going to be a ‘good father’ to his 14 year old baby-momma.
    It boggles my mind how a 14 year old can get pregnant. I cant even put myself in their position as to how they would think having sex without being prepared for the consequences would be somewhat of a good idea. Sex is a very well known cause-and-effect thing. Its not like they “didn’t know she was going to get pregnant”. Sorta like using a chainsaw not knowing that it can actually hurt you. Brain + Penis = bu-buy.
    Plus the parents, being so proud that their little baby is having a baby of their own. They need to be hit with a 2×4. Maybe they are just delusional, or seeing the silver lining of a very black looming cloud that tore their daughters future limb from limb. I could see if the child was 18, or 19, or 20. Hell, as long as the child is old enough to drive her ass to the pharmacy for her free Tylenol and pediacare. 14? Come on. Look how your daughter is dressed, no wonder why she got knocked up! Seriously, 14 year old girls are not people, they are property. They are property that YOU are responsible for. You may think that your little girl having a baby at 14 is cute and fun, but the huge glaring fact is that your daughter just screwed the pooch in the life department.
    So people are going to ask me “Well, say my daughter was stupid and got pregnant. What do you think we should do?”. Obviously murdering your daughter (and the penis she rode in on) is out of the question (heh). This isn’t a place for me to get on a soapbox and spray you all with my political and moral opinions (even though I just sorta did, oops). All I can say to this question is “Do what you have to do to insure that this child (if she decides to have it) gets the best damn upbringing that you can manage and have it turn into a success story, not another unproductive member of society”. Thats not really out of the question is it? That should be what every mother and father years for when they have children. Key word here is “Should”.
    Now I realize that there are plenty of success stories from people who had their first child at 14, and I’m sure I’m going to be up to my neck with hate-mail calling me an insensitive asshole. People will question why I am a pharmacist since I’m so full of hatred and bitterness. To those people I want to leave this parting line:
    She is 14, she did know what she was doing, and don’t say that it was not her fault because no matter how you slice it, it is. She has every right and power to not have this happen, but she didn’t due to laziness or stupidity. Personal responsibility. Learn to deal with it and keep it in your fucking pants. Just because you like to flush your future down the toilet over an orgasm doesn’t mean you need to leech funds allocated to help people who didn’t have a choice what cards they were dealt in life.
    Heaven forbid me to be the personal responsibility police pissing in your cornflakes and telling it like it is.

    Oh yay, another uppity Medicaid person.

    Usually I get a few bitches a month about my Clomid + Medicaid rant. About every other one is written by a complete idiot. You make the call as to which one this is.

    Are you stupid? Welfare and Medicaid are NOT the same. We’re not bums. WQe
    work. Medicaid is to help those who cant afford the high costs of
    insurance. So you’re saying someione who is dissabled and on ssi or welfare
    or medicaid is a bum?? Get your facts straight dummy. And you shouldnt be a

    Oh yay! Where should I start:

  • Welfare and Medicaid are not the same? Well according to Wikipedia: Medicaid is the United States health program for individuals and families with low incomes and resources. It is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities. Medicaid is the largest source of funding for medical and health-related services for people with limited income. That sounds pretty much like welfare to me.
  • I dont know where you got the bum idea. Obviously you are so ignorant that you walk around with a Medicaid chip on your shoulder looking for a fight. The whole rant you were complaining about was that Medicaid patients (who you say are “dissabled and on ssi or welfare
    or medicaid”) should not be entitled to fertility drugs. So am I mean for making a legit point? Or are you just an idiot for wanting to bring children into this world that you self-proclaim you cannot afford.
    I’m not against having children (unless you’re 14, more on that later), just not while you require society’s dime to survive. I guess common sense like that is why I’m a pharmacist and you aren’t.