Paging Doctor Sandy Pants…

The original post is here. TAestP didn’t want to field this one, so hell, its my duty to stand up for my loyal readers.
http://dinosaurmusings.blogspot.com/2008/05/rant-alert-attention-pharmacists.html

To the friendly, trusted neighborhood pharmacist who told my 74-year-old diabetic patient with coronary artery disease and arthritis to stop his Zocor because maybe that’s what was making his knees and hips hurt:
You fucking moron! Do you have any idea how hard I worked to get this guy to take this stuff in the first place? Do you know how long it took, how many visits over how many months of teaching, explaining, describing, convincing, persuading, cajoling and begging to get him to agree to even try this medication in the first place? Are you even aware of evidence-based guidelines that recommend statins for patients with diabetes and CAD? I assume you’re aware he has these conditions BECAUSE YOU FILL HIS FUCKING Avandaryl, Diovan and Procardia!
And guess what, asshole: his knees and hips still hurt. Think it might be osteoarthritis? You think you’d never seen that in a septuagenarian before.
So thanks for nothing, fucktard. No matter how hard I work my ass off trying to educate my patients about the need for their various medications, you go and undo it all — why? Because you can? Just to prove to yourself that patients hold you in higher regard than they do me? Think I can get you named as a co-defendant when he has a stroke and the wife sues because I wasn’t following the guidelines? No, of course not. You’ll just keep smirking there behind your counter, saving poor patients like him from us arrogant docs whom you claim don’t know one tenth as much about drugs as you do. Well guess what, you cum-burbling trout-fucker [thanks, CrankyProf!]: you may think you know all about drugs, but you don’t know the first motherfucking thing about using them in people.
So why don’t you go down a bottle or two of tylenol and chase it with a quart of vodka for good measure. Your basal metabolism is contributing to global warming, and there are slime molds who’d make better use of the oxygen you consume.
End Rant.

Are you mad because we undid your work with one statement what took you a while to accomplish? A bit bitter because your patients listen to US over you? Its okay, heres your ID card; Join the club. Not my fault that we spend more time with your patients than you do. Maybe if you didn’t take appointments and allowed them to just walk in to pester you they would think the sun rose and set on the crack of your ass like they do their pharmacist.
Now, after you have washed the sand out of your neither-regions, should you also maybe take what your patient says with a grain of salt? Say, like when YOUR patient comes to us and said “Doctor said I can have my Soma early”? Because we /all/ know that the PATIENT never gets what you say wrong. NEVER EVER.
Since the patient said that their knees and hips hurt, they probably pointed to their legs and said “It hurts me here”. I’m sure the pharmacist said “Talk to your doctor, the pain could be because of your Zocor” and the patient took that as “Stop Zocor”. Hell, the pharmacist could of said “Your Zocor is no longer covered, I’m faxing your doctor” as “Doctor told me to stop”. Old people don’t hear things correctly, you know this and I know this. I don’t care if another person “heard them say it”. If a doctor called me over something as stupid as this I would just say “yeah, whatever *click* ” just so you would stop wasting my fucking time. You don’t see us calling you to bitch you out for having a bunch of morons phone in your prescriptions and all of the retarded errors they make.
If the patient initially didn’t want to take Zocor (which you said that he didn’t) then don’t you think that MAYBE he was looking for the tiniest reason to stop taking it even if it meant taking things completely out of context? If your patient refuses to take it and dies, its not your problem. You said he should be on it, he doesn’t want to, end of story. Your patent could just be getting it filled and NOT taking it. Ever think that? Happens all the time. Just decided to rant on poor pharmacists over something stupid that your patient did.
Oh, and to shit in your punchbowl some more – if a 74 year old dies, I doubt they will sue you for not following guidelines considering HE’S FUCKING 74! Why doesn’t his wife sue God while she is at it. You should of made your story involve a 45 year old to make this point a bit.. uhh.. less retarded.
Heres an idea, Maybe you should have the Avandryl and Diovan reps talk with your patient, we all know that you’ll do whatever they say – maybe your patient will do the same.

Comments #

Comment by intern2010 on 2008-05-14 21:18:25 -0700 #

Congrats TaP for blasting this idiot. He seems to have gotten alot of people pissed at him now. His comments section has alot of people ripping him a new one.

Comment by applesoda on 2008-05-14 22:43:01 -0700 #

this physician has an unusual tactness of shooting himself in the mouth. from the evidence presented to him he’s come up with a false conclusion and overreacted. makes me question his credibility.

Comment by the little tech that does….. on 2008-05-14 22:57:10 -0700 #

You rock TAP! Keep up the great work.

Comment by Steph on 2008-05-14 23:06:27 -0700 #

We get bitched out all the time because the patients read the stupid medication information printouts or FDA-mandated med guides and then tell their doctor “The pharmacist said….” I tell the docs they should hear the things patients claim THEY said, like, “I think he told me to stop taking all my blood pressure drugs cause I’m gettin’ lisstatin now. For my heart.” Or, “My doctor didn’t tell me anything about my medication at all.” I get the last one ALL THE TIME, and I know it’s not true. Truth is, many patients don’t like taking medications, and look for any excuse to not take them, including blaming the pharmacist. It’s not entirely unthinkable that there’s an ass pharmacist out there who would worry way too much that a patient was developing statin-related myalgias and told the patient to stop taking their Zocor, but if that’s all it took to convince your patient to never take it again, well, that’s their responsibility. We pharmacists can’t collectively take the blame for all your patients’ various neuroses. Sorry, dude.

Comment by Marty on 2008-05-15 18:08:59 -0700 #

And when you can’t blame each other (which you are all so good at) then just blame the fuktard patients! We all know you are so much smarter than any of us anyway. So, blame away!

Comment by Christine on 2008-05-15 21:14:13 -0700 #

Wait, 74 year olds die sometimes? They didn’t cover this in school!

Comment by rph3664 on 2008-05-16 18:32:05 -0700 #

My dad was once prescribed 5 days of prednisone, and refused to take it because the handout said it could cause diabetes and osteoporosis. Well, yes, it can, if you take it for years!
He also once FedExed a Z-pack to my sister when she had bronchitis; he happened to have a refill. She did not take it, because it was not prescribed for her, and it turned out to be viral anyway. We know he was motivated by love, but things like this are one reason why we have resistant organisms.

Comment by nobody on 2008-05-17 07:24:12 -0700 #

Knowledge is a weapon and it’s just too sad that many patients use a tiny bit of it to unravel professional relationships. Maybe the monks had it right when they kept all the books locked up away from the masses. Don’t tell the laymen patients what kind of drugs they’re on, just give all their shit in one shiny pill, once a day, at the feeding trough.

Comment by http://openid.aol.com/PrePharmDStudent on 2008-05-17 10:56:45 -0700 #

Hey TAP
Have you seen one of the comments on this doctor’s – oops, I mean this “god-like being’s” blog? I’d love to see your response to this:
Bah! I used to think pharmacists were part of the health-care team. Stuff like this (and believe me, it happens all over) indicates such is not the case. A couple of weeks ago I was trying to call in a script for a patient. The pharmacist wanted to put me on hold (after already a 5-minute wait) because she was busy “counseling” a patient. I wonder where she thinks the “patient” came from? She had somebody to “counsel” because somebody like me wrote a prescription. I told her I would tell my patient to take their business elsewhere and called the script to another pharmacy. “Counseling”, indeed.
What. The. Hell. ??? I guess pharmacists are never busy (and doctors NEVER overprescribe, do they??) – and if the pharmacist is busy, then they need to drop everything whenever their lord and master MD calls – because we all know the PharmD NEVER “counsels” patients. They are too stupid and uneducated for that, right?? Not to mention that without MDs all Pharmacists would be out of a job—right?
I’m SO glad I have MDs like that to offer me advice on my chosen professional course of study. Just think – I am wasting my life by going into pharmacy! Thank God for God (I mean Doctors!)

Comment by Angry Male Nurse on 2008-05-17 22:58:42 -0700 #

I’ve been telling you all along TAP. You summarize the medical world in two classes: MD’s and pharms. The rest are NP’s, PA’s, nurses, chiropractors, massage therapists who give happy endings. But the bottom line is that the only profession MD’s associate themselves with is other MD’s. And they sure as shit don’t want to be associated with anybody who works at walgreens or riteaid, regardless of your education level.
You know who docs hate the most: their patients. Like a stripper who can’t stand the bastard throwing 5’s lie they were ones. He’s fat, smells bad, stupid, but the fucker is paying off. Notice the key words of sand in the crack of his ass: “My hard work”, “Sue”, “cum burbling”.
This is why their profession is slowly becoming irrelevant. Because they are assholes. And this is why after 4 years this janitor/nursey will get a cheesy 2 year degree and do his job for a quarter of the price. Will I do it better? Probably not. But I won’t be an asshole about it.

Comment by http://openid.aol.com/farett on 2008-05-18 07:57:05 -0700 #

First of all, any pharmacist worth the shit in his ass would never tell someone to STOP taking a medication. Its always “You should talk to your dick-gobbling Dr because…..”. And because an old person (I call em Gerrys) hasnt changed their hearing aid battery in 6 months, translates that to “Stop taking your medication or you will die”, the chocolate-starfish licking doctor gets pissed at us. News flash to all you doctors out there who think pharmacists are just pill pushing assholes who are out to fuck doctors in the ass…. WE KNOW A THING OR TWO ABOUT MEDICATION!!!!! On the other hand, I know how much you fuck-sticks know about drugs, as I am constantly calling to tell you that the dosage you wrote for doesnt exist, or to ask if youre sure you want to waste an entire bottle of antibiotic suspension because the total MLs you wrote for is 101.5 so we have to dispense the fucking 150ml or the 200ml bottle and tell the patient to remember to shove the remainder right up their ass because their doctor was an idiot. Hey “doctor” why dont you try writing a script like a normal person and not like the cereal prize in the bottom of the box, that you waited all week to get, tells you to??

Comment by screeb on 2008-05-20 18:46:00 -0700 #

On a similar note, and I have probably said this before after a few and forgot, in this day and age of pharmacists with advanced degrees, why are MD’s and their janitors, etc. the only ones with prescriptive authority? NP, PA, DO, all can prescribe, but the pharmacist has to get authorization from these numbnuts to make any drug therapy changes. They diagnose, we treat pharmaceutically. That should be the modern norm. Granted, I can’t perform an appendectomy, but I sure as hell can recommend a drug/insulin regimen for a diabetic, or a statin, or even an antibiotic if I know the suspected bug. Doctors have the market cornered and it’s time pharmacists got some of our own back. I’m not talking about CPP agreements, that should be a given right out of the chute with our training and education. And any good pharmacist will know when to refer and not overstep the limitations of his experience and education.

Comment by Jerry on 2008-06-18 11:40:34 -0700 #

I posted the below comment on Dr. Dino’s blog. You can choose to publish it or silently agree:
“Good on you Dino! Pharmacists are glorified cashiers that get a sense of satisfaction because they feel they are ‘saving lives’ from poorly or ineptly written scripts from MDs.
P L E A S E pharmacists, stop using this bullshit excuse that you are saving lives!!!
YOU COUNT PILLS!!!! PERIOD!!!!
Keep on Dr. Dino. Remember, your work and status as a physician is respected; pharmacists have cashier-level status and zero respect. (as it should be)”

Comment by mdcnmn on 2008-06-22 06:50:29 -0700 #

This guy is an idiot. The next time he wrights Pen VK for a pt with a penicillin allergy and the pharmacist catches it he needs to remember his words and eat them with ketchup. I spen half my day with calling MDs about missing info on rxs such as str, quantity, or directions. I have a voice mail system that is rarely used and have to grab the phone to take rxs that could have been left without interupting me when I am either couseling pts or doing the other 15 things I do every 10 minutes. Would the Dr like it if every time I called for a refill request I had to drag him out of from seeing a pt to ask for something as simple as can I get a refill on Mrs. Jones atenolol, I don’t think so. We should be working together as professionals not as advisaries.

Comment by Google Account on 2008-07-08 10:13:54 -0700 #

to paraphrase Margaret Cho-
Maybe we should get back to doing what we’re best at- hating 3rd party insurance providers.
I’m sorry that most medical education programs fail to teach anything about how to interact with a healthcare team in a professional manner. But jesus, try to teach them something that won’t have a board question directly associated with it and they act like you’ve just derailed the practice of medicine.

Comment by dorkyrph on 2008-07-08 12:57:40 -0700 #

mdcnmn,
Counseling? Since when are pharmacists in any position to counsel patients about their medications? (actual quote from an ICU RN I know.)
I know it’s our job to deal with MD mistakes, catch errors/problems, etc, but I get tired of getting my head bitten off every time I question some MD asshole’s shit writing or other mistakes. If they really gave a shit, you’d think they’d PAY ATTENTION, and clean up their writing to prevent the med errors RPh’s get sued for.
Oh well, the money’s not bad. But not as good as what the prick down the road gets who writes for Coumadin 100 mg daily.
I need a vacation…