ePrescribing for eIdiots

ePrescribing is the stupidest thing to come to pharmacy to date.  It serves no point, it causes MORE errors, plus it costs pharmacies upward of $0.30/rx to receive each prescription.
Lets take a realistic look at this.  Next time you are at work, tally up how many refill requests you send to doctors a day.  Now multiply that by $0.30 and figure out how much a month that surcharge will cost you.  You think that the doctors are paying thousands of dollars a month for this “service?” No! The brunt of the cost is placed firmly on the backs of the pharmacies who get forced into this service by the doctors.  Wait, it gets better.  You know that idiot in the doctors office who points-and-clicks their way to that eRx? Well if they screw up and make any changes (and resubmit it to you), its another $0.30!  Oh, but this time you’ve already filled the Rx and now have to RTS and redo everything.

Despite what SureScripts (and the pharmacies who suck their dick, mostly Good Neighbor Pharmacy and the infamous AmerisorceBergen) claim;  eRx provides absolutely no cost or time savings for pharmacies or pharmacists.  This is because:

  1. We have to retype /everything/ due to a lack of a standard sig code table between the 1000’s of pharmacy software vendors out there.  Not to mention that every pharmacy system has the drugs entered in differently as well.
  2. It costs us $0.30 for the “privilege” of receiving an eRx, $0.25 for the NCPDP transmission, another $0.50 for the vial and label, another $2 for the labor, and when you’re dealing with horrible PBM’s (mostly MedImpact, MedImpact, MedImpact again, MedImpact and BlueShield), you only make $drugcost + $2.  You lose money with every eRx you get!
  3. If the person typing in the eRx makes a mistake, its another $0.30.  If you fax it back for something that’s not covered and they respond via eRx, another $0.30.

If you can get your hands on the Good Neighbor Pharmacy bulletin, you’ll see how much GNP and AmerisorceBergen sucks the sweaty cock of SureScript.  Pharmacists just like you and I voiced their concerns in the GNP newsletter; and ABC and GNP pretty much said “well, deal with it.  You’ll make money we promise”.  Yeah… “Hi! I’m you’re wholesaler, bleed out money because I want to make sure SureScripts looks good”.  I hope GNP pharmacies are getting a huge cut on their wholesaler bill since now ABC is making business desisions for them.

Bruce Roberts, RPh, executive vice president and CEO of the National Community Pharmacists Association (NCPA), today hailed the move by AmerisourceBergen Corporation to enroll its Good Neighbor Pharmacy® network of independent community pharmacies as Founding Members of SureScripts, the nation’s largest network provider of electronic prescribing services.  The move will add more than 2,400 pharmacies to the SureScripts network.  NCPA co-founded SureScripts in 2001 to improve the quality, safety, and efficiency of the overall prescribing process.

Don’t say that your pharmacy associations don’t do anything for you! Now GNP pharmacies get ass-raped by their own for the low-low cost of only $0.30/eRx.  Here’s something about “quality, safety, and efficiency”: I have seen more errors, decimal point, and unit fuckups via SureScript eRx in one week than YEARS OF PAPER PRESCRIPTIONS.  In fact, I keep a file of all of the eRx fuckups that I get (it gets about 2-3 a day, that’s 15 a week) so when doctors say how WONDERFUL it is, I show them how many lives I have saved.  I’ve seen injection dose written instead of an oral dose, blatant overdoses, everything you can imagine.  I’ve even had controlled substances faxed to 2 different pharmacies 1 min apart for a cash paying patient MULTIPLE TIMES.  Hows that for safety and quality!

Now here’s the dirty secret of eRx’s, and why doctors have their panties moistened by its computer goodness.  You see, the “old fashioned way”, doctors had to sign each Rx they gave out to the patient.  However those days are long gone thanks to ePrescribing.  Now all some idiot has to know is the doctors password and ANYONE IN THE OFFICE CAN SEND OFF PRESCRIPTIONS.  That’s right, this bullshit doesn’t save the pharmacies any time, but it saves the doctor a bunch because its pretty much giving anyone who works in the office the power to sign and give patients legit prescriptions (even for controlled substances!)  Before, you had to steal the doctors pad and write out phonies, now anyone in the office with access to the eRx terminal can splatter out narcotics to every pharmacy that takes eRx’s and nobody would be the wiser.  Oh wait, SureScripts is all about safety and quality.

Did you also know that our omnipotent legislatures are trying to make ePrescribing mandatory for MediCare?  Boy, doesn’t that look really good for SureScript.  I wonder who’s hand is in who’s pants now.  Oh wait, remember Bruce Roberts of NCPA and co-founder of SureScripts?  He’s sucking the big O cock.  I wonder what sort of kickback he’s going to get if SureScripts becomes the ONLY ePrescribing outfit that is raping the backsides of pharmacies.  TRUST YOUR PHARMACY ASSOCIATIONS BECAUSE THEY ARE LOOKING OUT FOR YOUR OWN BEST INTERESTS.

An astute reader sent in the following (Thanks Angry Tech!):

You didn’t even go into how the government is MANDATING doctors to use E-Prescribing to avoid getting a reduction in Medicare reimbursement. (Best link I’ve been able to find is here)

Oh great, so now we’re FORCING the doctors to prescribe in a less-safe and unproven manner to prevent them getting a reimbursement cut.  Looks like the SureScript screwing is all around!  Lets see what Bruce Roberts says about all of this:

“I urge all independent pharmacists to get on board,” Roberts said. “Adoption of electronic prescribing is a critical step in moving the pharmacy profession forward.”

Wait, let me fix the quote so it reflects the writing on the wall:

“I urge all independent pharmacies to get on board.  Adoption of electronic prescribing will make NCPA and myself NOTHING BUT LOTS OF MONEY HAHAHAHAHA! *ahem* This is a good step forward for patient safety and moving the profession (retail is still around?) forward!”

SureScripts and ePrescribing is a solution in search of a problem.  This is how I would fix it:

  1. Flat fee.  Make it $50/month for unlimited transmissions.  If you can’t do this then stop lobbying congress, you’ll save a bunch of money by doing that.  Pharmacies are not going to shell out an extra $3-4k/month (unless you’re forced to by AmerisourceBergen) for the “privilege” of receiving what they got for free.
  2. Publish standard drug/sig codes and influence software vendors to work that into their software.  If we have to retype ANYTHING coming from and eRx, then its not worth a damn thing to us.  This includes typos from the doctors office.
  3. Don’t be such a douchebag money-grubbing company that is making up a problem to fix with its own expensive solution.

Pharmacy has existed for hundreds of years with sloppy handwriting. Why try to reinvent something better than will just end up being more expensive and more costly than an Rx pad and a fax machine.  I wonder what the legal fallout will be when we get mistakes injected directly into our pharmacy software vs putting them in ourselves.

Update: Dr Grumpy gives what this is like from his side of the fence.

The smells and sights of summer

Summer is upon us, and with it comes such delightful things.

The weather is warming up, and that means… BO SEASON! YAY!

For those new here, when the weather warms up, people start to stink.  Its not the subtle smells like cat-piss and just unwashed nasty that’s present during the winter months (because you don’t need to shower if you don’t sweat!™ ).  This is full on brown-underarm stains on that stretched paper-thin wife-beater stank.

Usually you can spot them coming as they walk in the door.  They are always:

  • Large
  • Breathing via their mouth
  • Swinging their arms like they are doing the twist when they walk
  • Dressed in a wife-beater stretched to its absolute limits while covered in various stains
  • Complain loudly about their Fatsomyalgia™

Now this is when as a pharmacist you need to really pony-up and exert your status on your clerks.  You make THEM wait on this guy.  If you don’t flex your college educated muscles, all of your clerks will scatter and find something more pressing to do (or use the restroom, all of them, at once) leaving you high and dry.  You always have your techs as a human shield, but these mouth-breathers always utter the words we hate to hear the most…

“I wanna talk to a pharmacist”

Just typing those words makes my fingers burn.  At this point, its every pharmacist for him/herself.  The PIC (pharmacist in charge) will throw down the PIC card, and then its whoever been there the least amount of time.  If you are fortunate enough to have an intern, they take the bullet for you, always.  If that intern doesn’t wait on that smelly fat-ass, then you fail (or fire) them for not doing pharmacist-in-training duties.

What adds insult to injury, is that its always some stupid question like “*gasp* WHERES THE MOTRIN *gasp*”.  Its never “WHERES THE SOAP” or “WHERES THE DEODORANT”or “WHAT ARE THE PHARMACOLOGICAL IMPLICATIONS OF TAKING EXTENDED RELEASE POTASSIUM WITH AN ANTI-CHOLINERGIC?” (heh, I’m a nerd, I amused myself with that last one).  Anyway, can you imagine what their houses must smell like?  Can you imagine what their bed must look like?  I wonder what shade of brown/tan their white bedsheets (if they just aren’t sleeping on a bare dirty mattress) are.  Remember kids, if you’re bad in life; you’ll come back to this world as THAT GUYS WIFE-BEATER OR BANANA HAMMOCK.  Now you all know where metformin comes from and why it smells that bad.

Enough about the smells, time for the sights!  Another wonderful welcome sign of summer are what people decide (or better yet, decide not) to wear.

Tube-tops are a wonderful thing, but like guns, alcohol, sharp weapons, and poop; they can be misused and cause a lot of damage.  Murphys law states that if a girl comes in your pharmacy wearing a tube-top, they are the girl who you would NOT want to see in a tube top.  Boobs are supposed to be in the uppermost part of the torso, be well defined and supported, and be pleasant to starelook at (especially if the A/C is cranked to sub-zero *ahem*).  They should NOT be one gigantic shelf that spans from your armpits down to above your belly-button.  Tube-tops are not a substitute for a bra or other feminine chestal support.  If you choose to wear such things, please choose a color that does not turn dark with sweat.  I don’t really need to see sweat-marks accenting your huge unbridled breasteseseseses.

This also applies to short-shorts.  If your fat wraps around the leg-holes of your shorts like the meat being pressed out of a sausage, please don’t wear them.

Tanktops with large arm-holes and no bra?  Yeah, the moment you reach down for something there’s going to be a whole lot of disaster happening.  Oh, don’t worry, you’ll see everything guaranteed.

Spandex anything?  I don’t even think this needs an explanation.

Just because you have a large chest does not mean a low cut top looks good on you.  I realize that it allows you easy access to the treasures you hide under your mommy-bags, but Murphy’s law states that the 0.24 seconds that I glance up I’ll see you doing something that will scar me forever.

Oh, and that one HOT girl who comes in the store wearing next to nothing?  You’ll be at lunch, in the can, or have your head buried in so much DUR/Insurance/Doctors Office madness that you won’t see and won’t care.  Thats how life is for Pharmacists.   If you’re hot, then please make yourself know to the pharmacist before leaving.  Dance, jump, do cartwheels, blow kisses, anything to remind us that the world isn’t full of fat and ugly people wearing spandex and wife-beaters.

Summer is also an excuse for ghetto parents to allow their toddler to just run around in the pharmacy wearing nothing but a dirty diaper.  If the filth and dirty on the outside doesn’t get to you, imagine whats going on INSIDE the diaper.  Its not the poor kids fault; hell, if I could run around a pharmacy with just my boxers I’d do it too.  However its the PARENTS responsibility to make sure that the kid has clothes on while in a public space.  Wait, there’s that R word again.

The big welfare mother rant.

This one is going to be a doozy, so please read the entire post before writing me a 10 page comment about your life story and how much of an asshole I am.  If you still wish to write me a 10 page comment on how society forced you to get knocked up while on welfare, then I’ll give you a story how society FORCED ME to use rough 2-ply toilet paper to wipe my ass instead of the good soft stuff.

Oh, and for the record, “welfare” here means full blown don’t-have-to-work-all-inclusive aid.  I’m not going to pick apart food-stamps but not free-housing or check, etc.  I say government ticket, I mean the entire government ticket.

This is how I see the welfare system working:

Girl “falls in love” at the ripe age of 16, and through the magic of laziness, hormones, stupidity, and complete irresponsibility allows herself to get pregnant by some loser.  The loser, taking  parenting advice from rap stars and TV idols, leaves that bitch and moves on (“hey, don’t hate the playa, hate the game”).  The mother, now single and with child, goes on the system to get assistance until she can finish school and get a job.  At which point she gets off of the system and pulls herself up by her bootstraps and becomes a model mother and a productive member of society.

That above I have no problem paying for.  Hell, believe it or not, that’s what the system was intended for!  However this is what mostly will happen:

Girl above, when her child is 2 years old, finds another douchebag reject and through the magic of not-fucking-learning-the-first-time gets pregnant AGAIN.  Repeat about 4 more times.  Kids run out of control and tear my shelves apart, and she bitches at me because the Septra suspension for kid #5 is grape flavored and not cherry.

Let it be known herein and throughout the tubes of the Internet.  If you are already on welfare, and you get pregnant again (ie: you already are established on the system and you spread your legs and accept seed again), you are the most irresponsible, stupid, waste of human skin on the planet.  You are nothing more than a receptacle for some dude to keep his sausage warm and serve no use to us other than to leech away our money like a tick on the ass-end of society.  Go and make porn flicks because your only mental and physical skill in life involves your mouth and between your legs.

It blows my mind how absolutely stupid someone can be to be on welfare (you know, implied that you cannot take care of yourself so the state has to take care of you) and bring another child into this world.  Getting pregnant once is a freebie in my book, shit happens (though barely now that Plan-B is OTC). The second time however is 100% you’re-a-fucking-moron.  The third one on is what-the-fuck-were-you-thinking (oh, you werent).  Birth control is FREE! It just takes a bit of effort (ie: getting off of your ass) to get!   Have they gotten the memo that welfare is not intended for living off of for your entire life?  Did it ever occur to them that if the welfare system suddenly says “Uh, no more money for checks, so sorry!” they are completely and utterly fucked?  Ugh, so retarded and so stupid.

Lets compare 2 irresponsible acts:

  • Spending your check on spinning rims instead of job-interview clothes: IRRESPONSIBLE
  • Bringing another human-being into this world when you are 100% reliant on the state to wipe your ass currently: REALLY-FUCKING-IRRESPONSIBLE

Usually if you cannot afford something; car, boat, whatever; it gets repo’d.  YOU CANNOT DO THAT WITH A CHILD!  Pregnancy isn’t some magical unknown event that just “happens”.  Its as preventable as avoiding getting your car stolen by LOCKING IT, or avoiding wrecking your car by NOT RUNNING INTO WALLS.  Which means that the only way these career welfare mothers are getting pregnant is out of sheer laziness and stupidity.  Surprise surprise!  Close your legs until you can afford to open them!

My solution, and one offered by other readers on here, is every 3 months, when you get your welfare paperwork reevaluated, you get a shot of Depot Provera.  I don’t give a rats ass about side-effects, these people are already on the downward slide, so we’re doing damage control now.  You want your check, you get your depot shot.  You don’t want your birth control shot? Then I guess you get no check!  The state pays for your life, the state gets to make the rules.  In “real life” if my boss asks me to clean the toilets, then I clean the toilets.  Know why? Because my job pays for my life, so my job gets to make the rules.  I realize that the “job” part is a foreign concept, but just trust me on this one.

I know I’m going to get at least one comment by some idiot saying that “reproduction is a right”.  Well, to them I say “Leave your gated community in your $60k SUV once in a while and open your fucking eyes.  If they have a right to reproduce like fucking rabbits, then I have a right to not pay a fucking dime towards the product of their irresponsibility.”   Seriously! Fuck and reproduce all you want, but don’t come to Uncle Sam asking for a double fist of government cheese.

So, I challenge you all to give me ONE DECENT point that refutes my belief that the woman who is on welfare and gets pregnant yet again is the most irresponsible person on the planet.

For your enjoyment (and since we’re talking about the pinnacle of irresponsibility), here is Octomom in a blender:



Really good rant on the subject at Violent Acres

The stupid will inherit the earth

According to the scientific trends that every pharmacist sees every day in a retail settings, the future of humanity will possess 3 major characteristics:

  1. Ugly
  2. Morbidly Obese (I’ll just use the “offensive” term FAT from here on out)
  3. Stupid

You see, characteristics #1 and #2 GUARANTEE (as in Billy Mays and the Sham-WOW guy GUARANTEE) that they will copulate with anything.  This is 100% fact, that the fat and ugly  will have sex with ANYTHING that says yes.  This applies to both male and female.   Note that you must be both FAT and UGLY.  I realize that “beauty is in the eye of the beholder, blah blah blah”, but how many butt-ass ugly women come into your store with a hoard of children who tear apart your shelves? Yeah; they put out, that’s how they got those fuck trophies.

Characteristic #3 will GUARANTEE that they will not use any sort of contraception, common sense, or planning.  It also GUARANTEES that they will be on welfare for the rest of their lives.  I realize that I’m painting with a broad brush here (who? me? never!); but how hard is it to get some FREE birth control or FREE condoms and USE THEM.  How hard is it to say no?  Pregnancy isn’t some magical mystical force where we really “aren’t sure” how babies are made, nor is it some knowledge reserved for college people like Krebs Cycle.

Now, due to overly-simplified-and-made-up-genetics, the offspring of 2 fat/ugly/stupid people will have a 75% chance of being fat/ugly/stupid UNLESS their parents have some sort of combo-breaker recessive gene that halts this downward spiral.  Rare chance I know, but when you have a litter of 6 like some of these women do, that gene HAS to surface.  Therefore 1 out of 4 children will grow up to be successful members of society who’s tax dollars are going towards his/her 3 fat/ugly/stupid welfare brethren whom are breeding out of control.

The time is now people.  Swine flu isn’t a pandemic, but the breeding of the fat/ugly/stupid is!

New backend, new layout, new beginning.

Many of you have emailed me asking why I have been so quiet the past month or so.  Well, now you know.

Welcome to the new Angry Pharmacist site!  Not having threaded comments (meaning you can reply to a comment, and your reply appears under theirs) really bugged me, and Moveable Type just wasn’t cutting the mustard.

So I found n6design and asked them for a new layout for WordPress.  They went all over town taking pictures of old stock bottles and tablets (I love the Viagra rocket, but the Soma balloon is the best) and even managed to take some pictures of an old Bates Stamping Machine.

The site otherwise should be the same.  Most of the old direct links should work, however I know of a few that are probably broken.  I’ll be adding more things (like twitter, can’t let DrugMonkey and TAestP get one up on me) as soon as I get most of the bugs worked out.

You pulled that from where!?!?

So obviously more than one of you have noticed that I’ve been quite silent lately.  Lawsuit?  Work trouble? Life trouble? Unemployment?  Nevah! Nobody can silence The Angry Pharmacist!

I’m working on a secret surprise for this site.  One that I’m almost completed with.  Its been a few months in the works, but I guarantee it’ll set this site apart from every other ripoff site out there.

I haven’t written a really funny entry about the public in a while, so here is something that has me disgusted, disturbed and really curious:  Why do women with big boobs hide stuff in their bras?

It blows my mind. I go out for a consultation, and I ring them up for their copays.  They stick their arm DOWN THEIR SHIRT, FEEL AROUND THEIR BOOB, THEN PRESENT ME WITH HUMID NASTY BOOB-MONEY.  About mid breast-exam I’m thinking to myself “Oh god, I hope they dont pull their money from there”, and sure enough out comes the wad of dollars (still steaming from sweat) as they proudly hand it to me.  Ew.

I shit you not, they should of just reached down their pants, and pulled it from their crotch. That’s how nasty this money is.  Its in that ‘moist’ (god I hate that word) phase where its neither sopping wet or humid.  Its at the point where you hate to put it in the register because it’ll just moistify all of the other dollars in the stack.

What makes this even better, is that I’ve seen them pull cell phones (sometimes ringing), checkbooks (moist and nasty), pill bottles (labels are all moist and falling off), money, car-keys, etc from their boobs.  Its like their boobs are little pockets of everything.  Whats better is when there are MULTIPLE things down between those mommy-bags so they must rummage around their boobs (not one boob, but both of them) while a store full of people watches in a mixed horror and amazement.  Sometimes Im afraid the’ll put out some food and start eating it, or some dead animal lost forgotten under those fun-bags.

However, what especially drains my soul is that the woman is always large, ugly, loud and sweaty.  Oh no, it can’t be some 150lb 19 year old with size E knockers feeling around inside of her shirt in my presence; it has to be the drenched in sweat, mouth-breathing, fatsomyalgic, 400 lbs with size FFF boobs.

People seem to have no problem with women doing this.  If I stuck my hand down the front of my pants and pulled out money, car-keys, my wallet, and a phone I would be hauled to jail.