Ive been writing on this site for almost 5 years.  I’ve noticed a few trends come and go.

1. Any post about crackheads instantly bring 100 page comments from legit pain management people explaining how they are not a crackhead.  This is besides the point that I make it very clear in said post what is (and is not) considered crackhead behavior.
2. Any post about crackheads instantly bring 100 page comments from crackheads justifying their crackhead behavior.
3. Students know absolutely nothing about the ‘real world’, except nursing students who know double-nothing.
4. The most common crackhead response is that we are a bunch of meanies, and are going to be replaced by machines.  Legit pain management patients don’t share the same views (go figure).

Lets look at the ‘replaced by machines’ scenario, bring some non-hydrocodone influenced logic to this and how awesome it will be for the average crackhead and patient.

Imagine there are no more pharmacists.  Your doctor gets his little PDA (or whatever) out, punches in the drugs, and zips it away to some super-mart with a eFill-4000 just humming away.  Lets just ignore the fact for a second that doctors cant send eRx’s correctly to save their (or yours!) life.  The eFill receives the order, and processes it along with the 50 other orders it has lined up.

You, crackhead, smugly happy that there are no real-life pharmacists any longer punch your refill in via the telephone, and stumble your way to the super-mart to visit your BFF eFill.  You put your thumb on the little pad, type your 4 digit code, and here is what you get.

ERROR: RX 459534 – LAST FILL WAS 6 DAYS 23:19:15 – CAN BE FILLED IN 0 DAYS 0:20:45.    PLEASE RETURN THEN.

(Yeah, the math is probably wrong for the days, I don’t care, you get my point)

Damn, 20 min and 45 seconds too early for your 30 day supply.  See, a human pharmacist would of just looked at the day, saw 30 days had come and just filled it.  Hell, you cant even get all pissy and argue with a robot!

Here are some more likely responses one might see:

ERROR: RX 4593823 – MD AUTHORIZED 4 DAYS EARLY FILL ON 2/24/10 – ADDITIONAL REFILLS PUSHED BACK 4 DAYS.

and

ERROR: RX 492343 – FEBRUARY ONLY HAD 28 DAYS.  PLEASE RETURN IN 2 DAYS.

I think you get the point.

How about the doctor decides to write you some blood pressure pills.  He sends it over to the eFill and tells you to pick it up in about 3 hours.  You arrive with your crisp $0 bill in hand for your state-covered copay when you read this message:

ERROR: RX 5393834 – PAYMENT DUE $234.00 – PRODUCT/SERVICE/NDC NOT COVERED BY INSURANCE (MEDI-CAL) – CONTACT PROVIDER FOR ALTERNATIVE OR INSERT CREDIT CARD.

Damn, because your insurance company doesn’t spit out what is covered (thanks Medical!) you’re left in the dark to decipher what is covered and what is not.  You don’t even have a helpful pharmacist to guide you in the right direction.

As the late Billy Mays used to say, BUT WAIT, THERE’S MORE!  You have really bad CHF.  To the point where you’re huffing and mouth-breathing to walk to the back of the mega-mart where the eFill is at.  Dr said he wants you to take something about an hour before you take your lasix.  Here is what you get.

ERROR: RX 4938532 PENDING FOR MD OVERRIDE – THERAPEUTIC DUPLICATION OF FUROSEMIDE AND METOLAZONE!

Isn’t technology grand?

As any pharmacist will tell you, there are a metric buttload of “interactions” that flash up on our screens.  About 1 in 40 are actually real-life interactions, the rest are just theoretical interactions that we have to override because lawyers reign supreme and nobody wants to get sued for “not telling us”. Only through the use of our SCHOOLING can we determine if an interaction is legit.  One interaction may be a non-issue in patient A, but its a huge issue for patient B because of drugs XYZ and surgery A.  You think the Doctor is going to keep up on interactions? HAHAHAHA *ahem*.  Doctors have a hard enough time using eScripts, lets not get carried away here.

There are just some thinks that a robot cannot do well, abstraction, application of unrelated data into related data, and fuzzy logic judgment.  Think of it from another angle: we have the technology with high-precision GPS systems, optical sensors, and super-fast computers yet we don’t have cars that can drive themselves.  We have cars that parallel park themselves, we have cars that alter the cruise control to avoid rear-end collisions, but they both require the judgment of a HUMAN (on a FUCKING CELL PHONE) to pilot safely.

Since I used the word ‘crackhead’, cue the 100 page comments about what part of your spine is fused together, all of the medication you are taking, and how I shouldn’t be a pharmacist.  I’m not going to point out the title of this site, because obviously basic reading comprehension went out when the hydrocodone went in.