Medicare Part D – D-Day all over again.

No no, I’m not going to give our dear friend Ken a good beat-down like some of you have been hoping.  I’ll get my revenge when he asks for his Vicodin and Soma a week early and his doctor and I (in some “fuck fuck paternalistic plot fuck fuck” tell him to go “paternally fuck” himself).  Besides, you all have shown him the errors of his life way better than I could.  Seriously, 50 comments and counting wasting this douche bag surprised the hell out of me.

Before I start bitching about old people and Medicare part D, I would like to bring to light the best comment I think I have ever received.

All you people who think TAP is so funny and so smart. You know who you
are. The ones who come here daily and encourage him and his behavior.
Will you still be proud of yourself when this human time bomb goes to
work one day and shoots up a group of innocent people? There is no one
more psycho and disgruntled than TAP. You people couldn’t care less
about him. If you did you would try to help him with his displaced
anger, instead of being the enablers that you are. I hope when you read
about him in the newspaper one day, you take your share of the guilt.

Wait, are you saying that there is nobody on this earth more psycho and disgruntled than me?  Oh how my heart flutters with bile and hatred!  Take that Angriest Pharmacist and DrugMonkey!  Have you gotten a comment saying that you’re a time bomb? Have you gotten anything that predicts you murdering a bunch of innocent people?  No!  Me – 1 and You – 0!  But realistically, “try to help him with his displaced anger”? Give me a break.  This isn’t a self-help group therapy site!  Lets all sit around the ScriptPro and sing songs of peace.  Obviously Marcia W, poster of the comment above, needs a big helping of the clue-bat to realize what kind of site this is.  Of course she agrees with Ken, so shes probably with Ken asking if he can get his narcs early if she pays for them with a two-party check.

Anyway, since this isn’t the Ken and Marcia show, and all of you “enablers” out there (50+ comments and counting!) are about to get fucked over on the first of this year, lets get back to the task at hand.

I have an idea.  Lets take a insurance plan and make it as complicated as possible.  Lets add shit like deductibles, a coverage gap (aka: doughnut hole), catastrophic coverage, multi-tiered copay systems, the works.  Now lets force the one class of people who have the least amount of understanding: The Old.  Now lets pawn the explanation of everything to our local pharmacist who we will pay $2.00 above cost for this service.  Lets send out ID cards with the wrong information on them as well send deceptive ads and salesmen around to complicate and confuse things even more.

That boys and girls, is Medicare Part D, and its the utter-clusterfuck of pharmacy.  They have made the absolute complex insurance plan possible and forced the old and stupid to use it.  Lets face it, the 65+ crowd aren’t the sharpest crayons in the box and are the most willing to bitch and moan.

On the first of the new year, retail pharmacy as a collective will either stick the proverbial shotgun in their mouths and pull the trigger, or will drink themselves into oblivion.  On the first is when all of the deductibles reset (and yes, you WILL have to explain what a deductible is to the same patient for the nth time in a row), plans merge, shuffle around, Argus and Wellpoint go down, etc.  Its going to be a mess.

However seniors, being old and confusable, forget about a few years ago when there was no Medicare Part D and they had to PAY OUT OF POCKET FOR EVERYTHING minus that measly discount the Medicare card gave them.  How quickly they bitch about $3.10 COMPLETELY FORGETTING they were paying $65 just a few years ago.  “I’m old and I deserve something.”  Yeah, well I’m not old, you’re using up the Medicare money that I put in but will never see, and I hope your little electric scooter shorts out in the parking lot so I can laugh at you.  You would think they would learn the routine now that Medicare part D has been out for 4? 5? years.  Yeah, you would think.

I’ve said it before and I’ll say it again, that Medicare Part D is a mean and cruel joke on the old and stupid and revenge on pharmacists.

I’m dreading the first

Comments #

Comment by rph3664 on 2008-12-30 09:49:54 -0800 #

I was still in retail when Medicare Part D(isaster) was announced, and whenever customers inquired as to why pharmacists were almost universally opposed to it, one of my colleagues always replied, “When it goes online, you will find out just how free it is.”
He was right.

Comment by Google Account on 2008-12-30 10:58:56 -0800 #

I’m still laughing about the “displaced” anger bit….
But they’d have had to work pretty d@mned hard to make Part D any more confusing than it is.

Comment by pharmacy chick on 2008-12-30 14:13:00 -0800 #

TAP,
yea yea yea, I hate the first also, but honestly, no “first” has been as bad as the “first-first” when Med-D debuted. its a good thing there wasn’t a shotgun nearby because either the Pharmacy Chick was going to use it on a customer or herself by the days’end. We are into, what?, year 5 of this nightmare? sheesh, I cannot even remember. What I do remember is 6 hour hold times at CMS, messed up adjudication, cards that didnt’ arrive, missing/incorrect information on the cards that did arrive, the dreaded dual-eligibles, etc.
Its honestly not as bad as it used to be. I think that many of the blue-hairs are so afraid of Med-d they don’t bother to change their plan, lest they mess up somehow and lose it entirely.
I never want to relive the first-first day of Med-D but it could be worse. They could unveil a Medicare D+

Comment by DKLA on 2008-12-30 18:40:19 -0800 #

TAP has also hit another sore point in pharmacy every January to mid-April (longest one I had in the doughnut hole…).
People looked shocked that Aricept would cost $400+ for a month prescription. Of course (for those that know what will happen), you’ll have to explain about it repeatedly for the next couple of days till the caregiver finally decides to get in on the action.
Ultimately it means another headache, ulcer, or forehead indentation.
I’m seriously going to beat the crap out of someone who sings “It’s the most wonderful time of the year.”

Comment by Pharmacy Mike on 2008-12-30 20:06:54 -0800 #

Unless I’m mistaken… Medicare D started in 2006, so we’re actually just finishing it’s 3rd year of existence.
Not that this makes anything you wrote less true. I would still love to meet the person that thought of the idea for the donut hole. Seriously… that has to be one of the dumbest ideas of all-time.

Comment by Stacy Without An E on 2008-12-31 16:23:17 -0800 #

The same genies who came up with Medicare, Part D are the same ones who want to instill a National Health Care Plan.
Can we all just drop the idea and use the ridiculous results of Part D as an example of why this is bad for the country?

Comment by VaTech on 2008-12-31 21:58:36 -0800 #

Ugh, i hate the first of the year. As a tech, i’m usually the one who gets to deal with the new insurance cards, the new questions, and the consequential ringing up of meds. Cue the yelling. Already we’ve gone through people storming our pharmacy …i’ve also had to deal with the usual “oh my GOD i HAVE to have this filled before the first of the year, what do you MEAN it’s going to be an hour?”
They usually don’t like the fact that 30 people had the same idea as them and about 96% of those filling either the 30th or 31st that HAD to have it before the 1st, all those scripts were dated 5 months ago.
But of course, it’s our fault insurance companies suck…our fault that certain drugs aren’t covered…our fault that brand name drugs do not have generics yet…it might as well be our fault that you didn’t get off your ass and bring in your prescription 5 months ago and now have realized that it’s the 31st and you’re screwed.

Comment by prepharmacist on 2008-12-31 22:17:12 -0800 #

I wanna talk about the BS PTCE. A large portion of the pharmacy technician cert. exam is irrelevant to the knowledge that a CPhT will ever need or use. I believe that this whole certification business is just so the government can have some type of reassurance that there is some kind of regulation and standards for technicians, however these are totally unneeded. A pharmacy technician becomes a tech. through experience not by taking some bullshit classes for some bullshit examination. Not to mention that the PTCB and pearson Vue must really enjoy the revenue they recieve from these overpriced exams.
I’d like to take it one step furthur. I believe that the whole Pharmacist role has become hyperinflated. I mean come on, Doctor of Pharmacy??? You got to be shitting me. It used to be that you could become a RPh. by getting a Bachelors Degree in pharmacy and getting experience. Now we have these 4 year schools that supposedly are needed now??? but we still have old RPh.’s and remember these guys are not that old, still working with new PharmD’s. I mean come on this is bullshit. you don’t need a doctorate to become the cornerstore druggist.
And don’t get me started on this whole CLINICAL bullshit. I mean, come on pharmacy residencies???? Lets get one thing straight:
The role of the pharmacist is to dispense. Pharmacists do not diagnose.
Pharmacists are not qualified to give medical advice. They practice pharmacy not medicine. Stick to the pills and tablets, don’t start picking up stethoscopes and needles.
Wake up Pharmacy, your way outta line.

Comment by FillMaster 5000 on 2009-01-01 00:12:07 -0800 #

“Thank you ma’am, that will be 298 dollars.”
*blank stare*
(oh, here it comes)*sigh*
WHAT!? What!!!? But, I only paid twenty-something dollars for it last time. Something must be wrong. You look it up on that computer doo-hickey of yours and see how much I paid last time.
“Yes, ma’am, you paid $29 last month.”
Well then, something must be wrong. It just doesn’t make any sense. You just go back to that computer doo-hickey thing of yours and fix it.
My beef is not so much with Medicare, but with the ridiculous cost of healthcare in this country, prescription drugs in particular. That’s what is bleeding Medicare dry. I don’t know how drug companies continue to get away with charging such astronomical prices for their pills. There should really be some legislation that limits it to cost plus a certain reasonable percentage, and that’s it. We’re sitting in an economic recession, yet drug prices keep going up and up and up.

Comment by Chris on 2009-01-01 01:11:40 -0800 #

Speaking as a UK pharmacist – mate, you need to switch to an NHS-type system. Everytime I look at your blog, I’m so happy that I don’t have to deal with insurance or medicare..!

Comment by Google Account on 2009-01-01 20:38:25 -0800 #

Ahhhh… New Year’s Day. Gotta love it. Here is a conversation I had numerous times last week:
me: Your insurance won’t pay for this until january 3rd
customer: But I want to fill it one more time before my copays go up!
me: Do you think your insurance company is stupid? Do you think you’re the only genius who has ever tried to “sneak” one past the insurance company. Do you think I’m going to call and tell them you’re going on vacation when you’re clearly not? NO! I will not commit insurance fraud so you can save $5. Thank you. Come again.
So January first is fun in all sorts of ways. 2 of the 3 major employers in our city have changed insurance carriers as of today. Cheers!

Comment by Some girl that you don’t know on 2009-01-02 01:44:51 -0800 #

I am such a sucker for a UK accent! Oh, where was I?
Buck up, little campers….just look forward to the brighter days after a couple of months go by. The everyday, joyous stuff we take for granted at the other times of the year.
Complaints when we tell them a copay for a new drop off, and they try to tell us that we are wrong. (I particularly like those cards that have the three tiers of copays printed right there in the corner. Establishing that, not only am I most likely correct, it took me three minutes to figure out their coverage tiers, using a card they’d been carrying for 1+years…but I digress.)
Complaints about a sharp increase in a copay, followed by a software search that reveals the same copay for the last 2 years. (I get a little nostalgic twinkle in my eye just thinking of my next chance to experience this.)
People bringing in incorrect/unsigned/undated CII scripts, five minutes before you close on a friday night. And mad that you can’t use that special red secret direct line phone hidden behind the counter to notify superDoctorMan, instantly, to rescue him/her from the fate brought about by the inadequate pharmacy staff.
I’m so looking forward to the joy of checking messages every mourn. (Nah, I don’t need to complain about the fast talkers…because surely, it’s pharmacist fodder,) but we can look forward to the folks that call at all odd hours of the night and not only leave the rx number, they share their pains/trials/tribulations of all illnesses they’ve ever experienced. (SPECIAL NOTE: If you are a patient, and calling in three scripts numbers at 2am –and the message lasts more than 15 minutes? You are likely providing way TMI) Oh, the fun we will have. (seriously, do I really need to hear mr. diverticulitis(sp?)/diabetic serior citizen dude holler at his hard of hearing wife to “hold on a sec! I’m on the toilet and calling in my refills!!! I can’t get up right now.—NOT a joke, a true,real message)
And we must not forget the joy the drive-thru brings. Besides the usual “patiently waiting” happy people, those seeking directions to a competitor, those wanting to borrow a cell phone? nuhhh nuhh nuhh . One guy even pulling up to ask a pharm tech if they serve pizzas ????) And now, just reminiscing about the tone of that buzzer at the window…makes me want to….
Anyway,for the next few weeks…… when you’re feeling down, when’t times get rough, when you’re weary, feeling small, when darkness comes, and pain is all around….just remember, better times are ahead. Your time has come to shine.

Comment by Mike W. on 2009-01-02 13:47:33 -0800 #

To Prepharmacist:
If you really plan on being a pharmacist, you should probably change your major now.
“The role of the pharmacist is to dispense. Pharmacists do not diagnose.
Pharmacists are not qualified to give medical advice. They practice pharmacy not medicine. Stick to the pills and tablets, don’t start picking up stethoscopes and needles”
The times they are a changin’. Years ago, and to some extent still today pharmacists had/have primarily a dispensing role. The training received in pharmacy school (I’m a BS pharmacist that went back to school later and got a PharmD) is more extensive than other health professionals that have prescriptive authority like Midwives, Nurse Practitioners, PA’s etc. Of course physicians are much more qualified to diagnose, but pharmacists are certainly qualified to give medical advice (at least I am). Within the next several years you are going to see a huge increase in MTM Medication Therapy Management and less of a focus on the dispensing role.
Then there is hospital pharmacy which is a whole different story. In most larger and definitely in teaching hospitals, pharmacists are much more involved with the “medical team.” When I worked at a large hospital, I went on the rounds every morning with the physicians and more often than not gave recommendations as to what medications to use for the patients. The MD’s followed our recommendations probably more than 85% of the time.
I do agree that a PharmD isn’t really necessary or the Tech certification for that matter. One of the best and most knowledgeable pharmacists that I’ve worked with was a BS pharmacist. It really depends on your work ethic and on the job training.

Comment by hickvillepharmer on 2009-01-02 16:23:15 -0800 #

Love the blog, very cathartic. As a new pharmacist, knowing that there are others putting up with the EXACT same shit has helped me keep my cool. That whole drinking thing…yeah, I can see the need 🙂
Medicare part D change-over has been fairly kind to me so far (we’re new, so volume is still ~150/day). Amazingly, everyone has been understanding. Several patients even took the time to call in their new info weeks ago as soon as they got their new cards. I almost hugged them when they came to pick up today.

Comment by KDUBZ on 2009-01-02 20:44:26 -0800 #

Medicare Part D is just another bit of evidence that if you want something to get truly fucked up all you have to do is get the US government involved. Who honestly thought about using the internet to provide information about plans to seniors? These people can’t even use the automated refill systems properly!

Comment by Jimbo on 2009-01-03 07:52:55 -0800 #

Asked an older lady yesterday for her new insurance card and she gave me her Allstate card

Comment by C. Lane RPh on 2009-01-03 11:28:33 -0800 #

I do not understand why the present Medicare Part D issues in pharmacy are an argument against National Health Insurance. However, I cannot toss the numbers around in an argument to suggest the present irritational situation in pharmacy revolves around just a few companies that have inadequate basic support i.e. the cards that do not provide adequate information, the hours on hold, the inflexible and non-pharmacist phone callers, irrationality of what will be covered, inconsistency of co-pays across the country, concept of ‘doughnut hole’, etc.. Are the majority of patients well-served? Do pharmacists’ problems just result from a couple insurance companies?
From my perspective, albeit myopic, a single payor system could possibly mean assurance of dealing with only one insurance company for the majority of clients (possibly with less glitches) in the attempt of receiving proper prescription drug reimbursement. What I would anticipate with one medication broker would be proper information, consistent co-pays, formulary, and more equitable coverage possibly ‘acceptable’ to the majority. Maybe this would favorably impact the phone handlers and less wait time–although I’ve answered phones from patients in the VA, and that process requires a patient that has a lot of time, motivation, and phone to solve problems.
A single payor wouldn’t necessarily be the same situation such as Medicaid with strict formulary requirements, nor like VA, again with strict formulary (plus a disadvantage of the governmental bureaucracy and funding dependent on annual authorization from Congressional apportionment of military spending). In my mind, a single payor could be tempered version of 1970’s version of the vast, limitless benefits of Blue Cross Blue Shield with a similar formulary to the VA.
From list of complaints with new year insurance multiplicity, it seems the irritation mainly involves inadequate and inconsistent insurance company support by various companies. And, the substandard interchange with pharmacists by these companies doesn’t seem to result in any quick and effective corrective actions.

Comment by Another Angry RPh on 2009-01-03 17:17:44 -0800 #

I love how everyone is just ignoring prepharmacist… Ignorance is Bliss, enjoy it “prepharmacist”

Comment by Ken on 2009-01-03 20:07:43 -0800 #

No? Oh no! No ‘official’ response from price gun vending machine boy? Heartbroken now. You’re just going to spew out some more drug abuse allegations, that’s the best you can do TAS? Well, if your ‘career’ is the best contribution you can make to mankind, then I shouldn’t expect anything very impressive from you in terms of defending yourself.
And you forgot to thank me for quadrupling your blog traffic. Of course, it was absolutely a rollicking good time to sit back and watch a few dozen of you middleman drones ‘defend’ your ‘career’ choices. It was highly entertaining. The fact that you are such vacant assholes and could only fire back with vicodin abuse smears and wholesale denigration of the mentally ill, really speaks to your character, and the depths of your degradation.
A small number of deep thinkers, obviously felt I raised some home truths. But on the whole, you’re as ugly a bunch as your blogs were before I ever commented. This is a key point, you see, in trolling, rarely does the tone of the blogger and commenters remain just as pathetic and sad before and after the trolling… this blog, and the other couple of fucktards doing these ‘angry retail drug dispenser genre’ blogs, were truly a wonderful ‘find’ in my internet travels… travels, which, when the occasion warrants it, I’m prepared to turn into wholesale trolling attacks, but only when confronted with a truly rare example of the most pathetic among humanity, which I have found in your blog genre.
It is simply breathtaking to see how miserable you people are, and your inability to see your own bullshit choices put you there. In the end, I’m just an anonymous man with unproven allegations of what is it? ‘vicodin abuse’? or myriad other puerile baseless attacks… unevidenced smears, on an unidentified man… that’s hardly evidence based medicine people…
At the end of the day, out of me and all of you sad clowns, my pointless career loving opponents, there is only one thing that has mountains of evidence… this blog is the evidence, going back three plus years… it is that TAS is a deeply, unsettled, miserable, bigoted, ageist, social darwinist, elitist, asshole cunt, with nothing but ‘complaints’ about the life he freely chose to enter. Truly, before I came across this blog, retail pharmacists, were just some unimportant dickheads in white coats I’d never really paid attention to… now after discovering a few of these ‘angry monkey genre’ blogs online, I can see what true pieces of work you really are… and I found it deeply hilarious. Side splitting fun actually.
And this brings a huge, toothy, smile to my face TAS… It really, really does. For in internet trolling, rarely is the prize of satisfaction so great, than to have absolute, and I mean absolute, confirmation with mountains of evidence… three years of blog post vitriol… that the opponent’s life is unbearably miserable and bereft of meaning. Basically you were just as evidently pathetic before I even commented. Your responses just provide more evidence.
It is actually the ‘grand prize’ of internet trolling. Not only, an opponent unable to defend himself like a man, but a man whose extraordinary psychic fault lines are on display for all the world to see, in such a visceral and true fashion, that I leave with absolutely no doubt, rock solid confidence, that you’re a miserable, unhappy, unfulfilled cunt, and that you’ll live and die have made absolutely no contribution but for complaining like a girl on the fucking internet about you’re unfaced career regrets, and your lack of balls to change the game and take control of your own life.
It’s all someone elses fault I know TAS, that’s what you think, but you made your bed fuck head. I’ve no respect for cowardly losers like you who would clearly benefit from a career change… maybe a fire watch tower in the deep state forested areas by yourself… but you scream get me out of here pal… your whole life screams ‘get me out of here’…. well… what is it ball-less asshole? a mortgage? a student loan debt? a lack of creativity? masochist bent? like to be unhappy? You’re a very deeply amusing study in people who are ‘stuck’… thank God you’ll have a little cash in exchange for the enormous thing you’ve sold to become a human vending machine, your life. One HELL of mid life crisis is coming in a few years… let us hope a big shiny red sports car is going to be enough to keep the community safe from you.
Again, one last time TAS, I spit on you, and thank you from the bottom of my heart, for the wonderful insight into what can happen if one lives one’s life on ‘autopilot’ and ends up in a complete pathetic joke of a career.
I’m real proud to share the planet with such an emasculated fucking rapist of what should be a man’s quest to lead a meaningful life. Don’t you have some ‘dispensing’ to do fucktard? Get back to it.
You’ve been a very entertaining aside. Your whole life is a ‘complaint’… aaaahhhahahahahahaaaah! Fucking hell pal. What a life. What, a, fucking, life.
Bwaaa hahahaa ‘shut up you junkie psycho, take your meds, I will not let you have opiates, because you’re addicted to them, I know this, because I don’t know you, and have no evidence…. bwaaaaaa bwaaaa help me I’ve fallen and I can’t get up…..’
What you need to understand TAS, and all other ‘angry retail dispenser cunts’… is the last three years of utterly sad evidence on this blog speaks louder than any half assed ‘response’ you’ve given me. The evidence of your misery is there for all to see… before you were hit with my truths. So don’t bother.
You exist only to cheer the viewer up. To remind us that we are not ‘angry pharmacists’ and thank fucking God for that. What a thing to be….
What a fucking thing to be. My fucking God. What a fucking life.
‘Bwaaaaa…. medicare makes my vending harder…. bwaaaaa… I have to explain to the low down fucking poor low IQ inferior blacks and elderly the newwwwww roooolz….. bwaaaaaaa’
‘bwaaaa YOU try reading doctor’s handwriting… bwaaaaa’
‘bwaaaaaa what’s YOUR career THEN? bwaaaa’
‘You’re addicted to pain meds, you’re also a schizophrenic. Schizophrenics need to be killed. Remove yourself from the gene pool… take your meds…. you’re lower than a nigger bwaaaaaa I deal with scum like you all day at my counter… bwaaaaaa;
‘He’s just jealous he’s not college educated…. he’s not you know…. I know him… I’ve got evidence….bwaaa’
‘I’m not going to serve you not time you come to the counter…. to get your ‘vicodin’ for you ‘addiction’ yeaahhh! take that! bwaaaaaaa’
‘I’m on the front line, the only reason you haven’t died like Heath Ledger of a drug interaction disaster…. I’m the guardian of life, the giver of life, I’m a hippocratic soldier of all that is sacred…. bwaaaaa’
‘bwaaaaaaa’
You truly are, a pathetic group of self important human losses. And I spit on you all. You’ve got nothing to offer, nothing to say, you merely complain and smear the community. You’re disgusting people. The BIGGEST, and most valuable, unshakable consolation I have, is just how unhappy I know you are. You see I ‘know’ this, I don’t merely assert it like you do with your smears on me.
You’re very funny, very predictable human resources, programmable to take my ticket and go to the shelf and get the item on the ticket and shut the fuck up.
I spit on you.
Not because you didn’t give me some kind of opiate that I never even took in my life… but I spit on you because your blog and personality was offensive before I even knew it existed, and nobody, could like what they see when they read your attitude to those who you presume to ‘serve’.

Comment by kiki on 2009-01-04 06:52:26 -0800 #

Hello angry pharmacist!
Could you give your readers a GREAT piece of advice and tell them unless they can possibly avoid it to NEVER get their scripts filled on the 1st day of the month!
As you say a 30 day supply is just that, 30 days, now when most days have 31 days it can cause problems. Especially during holidays. Because your insurance WILL NOT pay for the same meds more than once per month. At least wait until the 2nd or 3rd to be on the safe side.
Does that even make sense?
The reason I say this is because I am one of those people who had to get my meds filled early (2 months worth) to get sorted for vacation. I let them know 2 weeks in advance so it wasn’t a problem getting them because my dr. OK’ed it. I take Norco for degenerative bone disease and Nexium for digestive problems. Now I NEED both of these to function, but WHOA. When I payed the bill at the pharmacy I was a little floored. The Norco wasn’t TOO bad (worse than my normal $20 co-pau but do-able) but the Nexium, WOW. I had no idea it was so expensive. But as I said I NEED them so paid of course.
When I get my meds filled when we come back from holiday though I will make sure I get them around the 3rd or 4th though, even if that means going a few days without my meds. It’s not like I’ll die if i do that or anything.
Am I crazy or is it just easier on EVERYONE not to get things filled on the 1st because of running out on the 30th? Or am I just still reeling from the NExium bill? ha. Thanks, still loving your blog!
One more question. What is the deal with this Soma stuff? Is this something new? I know you’ve always went on about Hydrocodone etc. what exactly IS Soma? ( I don’t want any, just curious as to why it;s became so popular so fast?…) Thanks!

Comment by rph3664 on 2009-01-04 14:23:34 -0800 #

Ken, do you really think anyone actually reads your posts?

Comment by Crusty RPh on 2009-01-04 14:43:51 -0800 #

Looks like Kenny is off his meds again.

Comment by Crusty RPh on 2009-01-04 15:05:54 -0800 #

Ken, Ken, Ken — Anyone that feels that way about any profession or job has never lived in their shoes. If you haven’t noticed, this blog’s target is incompetence and indifference in those who don’t do the best they can, whether it be a pharmacist, tech, intern, nurse, Dr., insurance co. or patient. I must admit you are best schitzo I have seen in my 40yrs. as an RPh. Next time you pick up your meds, take a second to talk to your pharmacist. If you use mail order, they have an 800 number for you. They will take the time to explain the necessity of consistant therapy — don’t miss a dose. You are right tho, your rants do help this sight. If you shorten them, I might acutally read the entire thing. Think about doing an outline first and taking it point by point rather than all over the map. It makes you sound, maybe accurately, fucking nuts. If that fails try an extra layer of foil on your windows.

Comment by richardson wife on 2009-01-04 20:24:38 -0800 #

Dear Angry Pharmacist,
I promise I HATE and love pharmacy more than you…
There is a crazy bitch who feels we should pay for her sleeping medication because it was overlooked when the other dozen plus medications were filled. No one else called in all there medications the last week of the year…only her….NOT. Pharmacy ads should read, “Humans need not apply.”

Comment by KDUBZ on 2009-01-04 22:46:40 -0800 #

Ken,
I made over six figures last year, do you really think I am miserable? You can call me anything you want for that much money. Hell ask your mom what she lets people do to her for money!
On to another matter, I thought you were never coming back. Feel free to add me to the long list of people you have dissapointed in your life. Although maybe its not the real “Ken,” just look at the lack of “paternalistic” and “superfluous” in the post. How sad, not even a full on douchebag, just a copycat douchebag.

Comment by chemoqueenrph on 2009-01-05 16:02:22 -0800 #

C. Lane,
Do you really work in the US Healthcare system? I embrace the concept of universal coverage for all. However, Medicare Part D is just one example of the complete clusterfuck that the US Government perpetrates on the entire healthcare system daily. Medicare Part B is just as complicated. And they change the rules quarterly!! Most healthcare institutions and healthcare providers depend mightily on the reimbursement for services paid under Medicare Part B. Some drugs are covered under Medicare Part B (hospital, hospital based clinic, MD office) and some drugs are covered under part D. If it’s a Medicare part D plan administered under contract with a private insurer, different rules as well.
Then you add in that Medicaid has different rules that are largely determined by each state.
Then the VA system is different as well.
And then throw in the hundreds, if not thousands of payers (private insurance) that all have different rules as well.
It’s all about as easy to follow as a Ross Perot flow chart.
If we could just have ONE single payer and everyone played by the SAME rules, it would truly make life simpler. However, I don’t trust the US Government to always make coverage determinations based on the best interest of the patient. Look up darbopoeitin coverage on the Medicare website. Over the course of the year, Medicare took a safety warning, blew it completely out of proportion, and now more cancer patients have to get blood transfusions instead of a simple injection to stimulate their body into making more RBC’s. If the goal of chemo is curative, then yes it makes sense to use ESA’s judiciously. But if the chemo is not expected to cure the cancer, but hopefully keep the patient alive longer than without chemo, then those patients would benefit from a kinder, gentler approach to anemia management than to have to spend 6 hours in a clinic getting a blood transfusion. Me personally? I would rather get the Aranesp than a blood transfusion. Save the blood for trauma patients and those with conditions that can’t be helped with ESA’s.
The fact that many oncology clinics lost millions of dollars on ESA’s the government refused to pay for has left a very bitter taste in my mouth.
Dealing with Medicare is like having to file your taxes weekly. It’s that ridiculously complicated. It’s a big fucking shell game all the payors play to get out of paying as many claims as possible. Some insurance companies have been known to throw claims in the trash. Then when they are questioned about why the claim was not paid, they say it is past the 30 day window to file the claim. So too bad for you, we’re not paying for that MRI.
And don’t even get me started on 340B.
I love reading TAP’s blog because even though the shells we play with daily are different, we are all still getting fucked in the ass by the same big daddy.

Comment by neumeindil on 2009-01-05 21:00:51 -0800 #

Our most veteran pharmacist (licensed since 1971) and a 10 year career tech both took vacation this week.
I don’t blame them a bit.

Comment by Mike on 2009-01-05 21:45:08 -0800 #

I think Ken is the same sort of person who thinks that all police officers do all day is write speeding tickets … the mindless sort of work that occupies most of their day. The tough/dangerous part of police work is obvious to the public, but the tough part of pharmacy isn’t always such. Like police work, 95% of pharmacy work is routine and honestly, pretty easy. The other 5% of the time is when the pharmacist’s expertise and professional judgment can greatly affect someone’s health. Most of the public isn’t exposed to this 5% of a pharmacist’s job. Most people are healthy and aren’t on that many medications and that’s the way we want it — it shouldn’t be a huge ordeal when you get a new medication prescribed. But sometimes a pharmacist is the only thing there that prevents a very dangerous medication reaction … whether it has to do with a drug-drug interaction (prescription or OTC), patient administration, appropriateness of a drug, or drug dose/stength. Let us not forget the dozens of OTC consultations we do everyday (for free). That in itself helps many people who would otherwise be taking OTCs that are ineffective or potentially dangerous. Ken either: A) Has had a bad experience with a pharmacy and wants to pretend that the 5% doesn’t exist B) Really has no understanding of what a pharmacist does C) Doesn’t really believe anything he is saying and is just having fun. In any case, I’m glad that he is stirring up debate at what a pharmacist should be doing. We shouldn’t be screaming at this fellow, we should be explaining to him why a pharmacist is important and why our salary is justified. It’s not always obvious to the layman, and that’s okay.
TAP isn’t speaking to the masses (like Ken) … he is speaking to the people who share the profession. He speaks about universal situations in the profession in an entertaining and extremely humorous fashion. It’s too bad that the outsiders can’t find the greatness in his posts. I think he really enjoys his job deep down, but is just too damn good at portraying the dark side of the profession to say so.

Comment by Oz Pharmacist on 2009-01-06 04:07:31 -0800 #

LOL @ Ken
Quite hilarious really calling pharmacists a waste of life blah blah blah when by his own admission he seems to go around and troll blogs to get a response.
– Work for a living
or
– Troll blogs with huge comments that would take a while to type up.
Yep, someones wasting their life… but I don’t think its us.

• Notice Ken I didnt call you schizo/addict etc – you’re just a sad sad little man with your computer and the internetz to keep you company. I really do feel sorry for you.

Comment by Steph on 2009-01-06 09:42:13 -0800 #

Ken hasn’t found anyone who will pay him for what he feels is his specialty–being articulate–so he does it for free. He’s hoping to be discovered some day, but he can’t hold a job because he is morally and intellectually superior to everyone else–nobody understands or appreciates him. So he medicates with Vicodin, or worse–someone has told him “no” too many times and he’s bitter.
Unlike Ken, most of us really do know our place–we’re quite comfortable with it. We love our regulars and the bulk of our patients who think and act rationally and thoughtfully. These interactions are our bread and butter and aren’t so interesting to describe in a blog.
As with all jobs, where what people do is called “work” and where one must be paid to show up, there are stressors, most of which in our profession are repetitive. And those of us who are successful at managing such issues often must maintain a sense of humor and see the irony in these situations.
Ken, this blog isn’t FOR you, it’s for those of us who know what each other is talking about, is thinking about, each hour of each work day. When we come up with creative and kind ways to explain for the hundredth time why someone’s medication costs as much as it does–to explain the little codes that come out of the machine you so love, even in our utter disbelief and astonishment at the thickness of so many people–that’s good customer service. So is politely refusing an early (again! surprise!) refill of narcotics to a desperate regular. Or, answering the same question for the same person over and over and over again–nicely, as nicely as we humanly can…. And when we are paid to show up day after day after day and do this over and over again, that’s called professionalism.
Ken, you’re a smart guy–you’re welcome to join our ranks when you can get accepted to a pharmacy program at a major university and pass all your classes–even the boring ones–and stick with the program, then pass your licensure exam.
You’ll put in time as an intern and if you don’t make a really bad mistake, and you work hard (yep! It’s work!), you’ll become a real live pharmacist. You may know the joys of protecting patients from prescribing errors, or drug interactions, or even, Ken, people such as yourself who would, if left to their own device, overmedicate themselves to hepatitis or respiratory failure, or, worse, in turn, sell their vital narcotics on the street for fabulous profits–(uh-oh, more middlemen, Ken!–only these guys don’t care whose mother or child they kill.) You may feel a sense of satisfaction when your education and experience comes into play and you avert a medication-related illness or death.
Until that happens, we don’t expect you to understand our role. Clearly, your lack of understanding has led to immeasurable frustration and anger–you’re “Angry Troller”(c), Ken! Awesome!
Now, if you were a licensed pharmacist (remember, you’ve gotten into the program, you studied because nobody is THAT smart, you showed up, you passed, you worked–all that), you may be better at being lied to by desperate people, or at watching the worst of humanity displayed before your very eyes and ears–the lying, the cheating, the destruction, even the stealing.
You’ll likely, as we do, adore the little old ladies who are sweet and smart and polite, and the gurgly babies who look much better today than they did last week with that fever, or the excellent questions from the guy with the new statin prescription–he’s cool. These people will totally make your day, if you’re lucky, Ken. I suspect you will not appreciate it when you are asked to drop everything you’re doing for these people in order to help the types of folks who are regularly described in this blog.
This blog, you see, and others like it, are written by people who live the life, who’ve paid our dues, who work with the system we have, who have integrity and professionalism, and who just need to vent a little, because, believe it or not, Ken, it is possible to do all we do with courtesy and a smile, even when we don’t feel like it.
Good day, Ken.
Can I make one little suggestion? Back away from the computer for a couple hours, maybe take a little walk and a big personal inventory–how’s your social life, your weight, your health, your family life? Maybe you’d like to get some counseling for your anger–maybe fold up the laptop for a while, turn off the political radio and enjoy nature for a time?
Maybe you’d like to help someone else for a change?
We pharmacists do that every day. It’s nice.

Comment by ADHD CPhT on 2009-01-06 19:18:42 -0800 #

LOL- I got bored 1/4 the way through Ken’s post, not that I took it seriously anyway; not only do I think he doesn’t mean any of it, I think ‘Ken’ is Angriest.

Comment by Steph on 2009-01-06 20:08:07 -0800 #

Oh, and, Ken, you are thinking along the right track with regard to having pharmacists replaced by machines.
They already exist–mail order.
Unfortunately, they make mistakes, and their work still has to be checked by a human.
As for software, we get help there, too, but wouldn’t you know, it takes a human to interpret the drug interaction warnings, to determine their actual vs. theoretical harm–it’s complicated, and you’d understand if you were–you guessed it–a pharmacist.
You’re also right that many people could look up their own information on the internet. Many do, in fact. Saves us a lot of time, usually, if people know what’s good information and what’s not so good–you know how that goes. There’s a lot of not-so-good information out there.
That’s where we come in. We talk for free to people who don’t want to use a computer, or who can’t use a computer to access drug information, or when they have questions about it.
Also, the whole thing about doctors handing out drugs? They don’t wanna. There’s a lot of documentation that goes along with it, a lot of insurance and payment issues, a lot of discussion and preparation and clinical checking and questions and, trust me, the docs are SO glad they’re not doing that on top of what they already do. Then, too, they wouldn’t do what we do for the pay we get, which, although pretty decent, is not what a physician makes. I can’t tell you how many times a doctor has told me, when I questioned his or her prescription, anyway, “Thanks for catching that.” You see, we work together to provide pretty good care for our patients.
We know our place.
We’re pretty cool with it.
You wouldn’t understand.

Comment by steve on 2009-01-07 08:23:22 -0800 #

ken…..when pharmacists are mentioning about Vicodin addicts and all the other problems, it is because it is a big problem. I have worked at many different pharmacies and it is a big problem at every pharmacy. Just a thought ken…. peel yourself away from your computer go get a job with a pharmacy and you will see how oblivious you are to the whole damn situation. Until then shut the hell up.

Comment by George on 2009-01-07 13:55:39 -0800 #

I have just been delighted to be made aware of this site recently. I’m a pharmacy student and work in a pharmacy. I couldn’t agree more about Part D. It really is a pain at the first of the new year. On a side note: Y’all that don’t know a damn thing about the pharmacy profession really need to shut the hell up. Prime example = Ken. Seriously, do you think anyone actually cares what you think? You try to sound like you know what you are talking about, but you are the captain of the FAIL BOAT!

Comment by Mike W. on 2009-01-08 09:53:56 -0800 #

It’s not a suprise that Ken has decided to throw racism into his repertoire. Way to get your point across. Oh and by the way, putting quotations around the word doesn’t make it any less your word.

Comment by VegasAgent on 2009-01-08 15:27:45 -0800 #

I’m one of those salespeople that get into the mix with Part D. I haven’t had a Winter vacation in 3 years! The 6 week open enrollment period sucks really hard. TAP, I feel your pain. I try my best to educate my clients so they come to you knowing what to expect, but it doesn’t always happen. I’m really sorry.
How soon they forget- 3 years with a crappy Part D plan was SO much better than what they had before. I’m all for making it less confusing and more user friendly, but something is better than nothing.
Hang in there! I fully support my TAPs in the hatred of insurance company’s insane rules!

Comment by Just a pharm tech on 2009-01-08 21:09:16 -0800 #

Ken makes me LOLZ
I <3 you TAP!

Comment by Google Account on 2009-01-09 13:34:31 -0800 #

the shit’s flying everywhere and i’m taking cover in a hole for lunch. a dear sweet grandmotherly type just called and informed me rather confidently that she “does not have co-pays and she’s not paying $85 for her rx’s today because they should be free. remember last month?”
sigh. straight ketel one tonight.

Comment by Dave on 2009-01-10 18:49:02 -0800 #

I kind of wonder of that guys saying that TAP is going to be shooting up a post office pretty soon isn’t going to also do so him/herself. YES, TAP is somewhat unhinged sometimes, but then all of us in the medical field are (whether an MD like me or a R.Ph. like TAP) to one degree or another. It is the people that we treat that seem to think we are their to confirm their terribly unhealthy lifestyles are really OK, tell 400 pound 5’2″ guys that they are really NOT that obese, and tell people who insist that the only thing that will treat their blood pressure issues is Vicodin and Soma, taken together every 3 hours at dosages over 100mg’s an hour that they are, in the end, probably right, that make ALL of us want to put on pantyhose over our scrubs, climb to the top of the University of Texas Tower and try to sniper people with soda straws. TAP may possibly be crazy – but there is an old saying that every health professional’s attitude and ideas are a reflection of the patients that they treat everyday. On the other hand, let’s hope that old saying is one that is NOT true. If so, I am a cross dressing, sheep banging, dwarf anal loving transvestite who likes to date otters. Give TAP a break, he is clearly no worse than the rest of us.

Comment by need-a-refill-NOW on 2009-01-12 09:24:52 -0800 #

I do say TAP that i love your blog and check it Q6HRS. “WE” are all waiting for some good rants! alas we havent heard from ya in a while, I hope your ok im worried abit oooh by the way REFILL MY VIKO-DAN AND SOMAZ EARLY 🙂

Comment by C. Lane RPh on 2009-01-12 09:36:55 -0800 #

ChemoQueen–I ‘do’ chemo, too, and ESPs, as well. It is my understanding that the ESP flap was initiated by the government to limit use of the drug for patients whose HCT was above a certain level. Thereby, the government was in a position (regulatorily, as well as for reimbursement) to point out to drug companies their own data that showed higher rates of death in a population that used the drug when HCT was higher than a certain percentage.
While I do not know the impact of long-term effects to patients especially those with cancer (not necessarily on those patients on dialysis), I do know that at the time I was writing the Aranesp monograph for our hospital formulary, ESPs were the most widely used expensive drug in the world, especially meaningful when they were used to extend life-spans, in a way no other drug could possibly do so.
Admittedly, I’m not in the business office, but it seems to me, that if there was one payor, a lot of frou-frou rule changes would be consistent for all patients, and thus easier for a medical profession to work with insurance ‘head-on’ rather than having to deal with idiosyncrasies in each plan (in each state).
Although this has nothing to do with Ken, and everything to do with Medicare D, my premise is that one payor would simplify the whole shooting match. That may be a false premise, but I’m open to as to why it wouldn’t work. One payor would have to NOT be like the VA, as a branch of government that possibly wouldn’t be funded properly from year to year–maybe, it’d be like the bank bail-out, since everyone would be affected by its ultimate success, and all citizens would simply HAVE to make it work?

Comment by intern2010 on 2009-01-12 22:28:31 -0800 #

I spent of lot of time yesterday when I was working explaining, that it is the beginning of the year and therefore copays change and you have to meet your deductable all over again. A good number of people just said they though so and paid, the others gave me the dumb cow look and asked me to waive the copays this time, of which since it’s not medicaid, they have to pay if they want their drugs.
Also had a couple of people come in for an antibiotic and vicodin and low and be hold only one decided to get both, the rest just want the vicodin. And of course I got the “I’ll be in tommorow when I have more money” excuse when their copay is probably averaging 5 bucks or less for their penicillin or amoxicillin but they then have no problem dropping alot more than that in the front of the store on crap. Watch none of them come back for the antibiotic, of course the strangest comment I got from one of the pain med only patients was “oh, I have penicillin at home, I’ll just use that.” I could be wrong but I really doubt that is the case and I’ll be returning those antibiotics to stock in a week or so.

Comment by http://openid.aol.com/snowfire1910 on 2009-01-13 09:55:40 -0800 #

My name’s Taylor. I’m 15 and me, Jimmy, and Vin ce read your blogs every 7th period in Comm Tech 2 class.
Just wanted to let you I think you’re great and Ken needs to go play in the traffic with the anti depressants you gave him for not having a life.
=)

Comment by UrbanRxTech on 2009-01-14 10:27:57 -0800 #

We miss you, TAP. Where are you? Hope Medicare Part D didn’t do you in….
Oh and to Ken: Get a life. Nobody wants to hear your senseless rantings.

Comment by Google Account on 2009-01-14 12:16:40 -0800 #

I’m an intern and work with what some would call the “Trifecta” of patients: poor, uneducated, and urban. I would venture to guess that only 15% of my patients AREN’T on some kind of government-aid assistance program. Not that that’s wrong, it just makes things really, really complicated.
Say, explaining a Prior Auth…or why Medicaid upped their co-pays by a whopping $0.05…or even what a deductible is…
Through the frustration, I’m actually starting to feel bad for these people. It’s not their fault the system was set up to be as complicated as humanly possible, the system failed them. So now, because people’s coverage is changing and they don’t realize it, they don’t pick up meds and we end up returning ~30% of our filled scripts to stock after waiting two weeks. So my store is essentially taking the time to fill the script twice. And then they wonder why our store’s wait time has lately averaged around 3 hrs.
Also starting January 1st, to add insult to injury, one of our local hospitals has decided to switch it’s coverage to an HSA/FSA type program. You would think as healthcare providers they would properly educate their staff about the differences between the standard coverage they had been receiving and this new type of coverage. Oh, no… So I have this lady bring her new card, and it looks just like a regular Visa. I get the information, give her the card, and an hour later am at the check out window when she comes to pick up. Apparently, no one told this woman how FSA’s work. I got my ass reamed. How much my store sucked, and ripped people off, that we were such fuck-ups, blah blah blah. So I keep my cool and try to explain to her that this is a different card than last time and what to expect, etc. She would have none of it, took her scripts and left. I actually feel sorry for that poor Customer Service rep that had to try and explain this to her. Actually, no, I feel sorry for myself, because we all know that the insurance customer service people are all mentally retarded, so next time she comes in, she will have no better understanding than she did the first time around and we’ll keep going on this vicious cycle. Joyous…

Comment by intern2010 on 2009-01-19 20:22:53 -0800 #

I got screamed at alot by the people that come to the store I work at this weekend. While not all of them are on goverment assistance, probably 35-45% are. Of course basically all the NYS programs have dropped Nexium and alot of the other PPIs from the formulary so not even getting a PA will get them covered. Alot of people were pissed off when we told them this as it seemed like everyone and their extended clan are on nexium. If it wasn’t bad customer service and more imporantly against corporate policy, I’d have a huge sign saying something along the lines of “Don’t bitch at me about your copays, 1 month vs 3 month supply being covered, or your drug formulary. Take it up with the plan provider” After dealing with the same complaints for days, it starts to get really annoying, especially when I’m feeling like crap from the common cold.

Comment by its only me on 2009-02-27 13:42:34 -0800 #

This fuckin miss is all the manufacturers fault. If they wern’t so arrogant and so fuckin greedy, we wouldnt have a problem. All they care about is money money money! They don’t give a continental fuck about anybodys health, yours or mine..its all about the bottom line…all about the money!!!! If they were not so completely fucking greedy, they could sale their products at a reasonable price, and everyone could afford them.
Would’n need insurance, 3rd parties, fucking greedy PBM’s,part D..So..fuck the manufacturers..every last one of them!

Comment by V on 2009-05-21 19:59:53 -0700 #

Wow, Ken. Get a life. So basically, all you do is spend your free time degrading people for getting out their frustrations? That’s not only rude, it’s annoying. You’re totally not looking at this in perspective. Yeah, there’s a lot of angry blogging, but did you ever look any deeper than that? Probably not. Some people like to write it out when they’re frustrated… and if people read what they wrote… maybe something could get fixed. Your telling me you work in Pharmacy and are never disappointed? That comes with every profession, not just this one. Go troll on their sites, I’m sure they’ll love hearing from you. You are a self-centered asshat and you should look a little more deeply into situations before making a three-page-long rant about how you disagree with all of these people. Didn’t your mother ever tell you? ‘If you don’t have anything nice to say…’ You just love to read and reread your posts, don’t you? I wouldn’t be surprised. I mean, if you make a life of trolling.