Now the last few entries haven’t been very angry. This one is to make up for that.
How many of us have been merrily working along, to have some fucking douchebag come into your store and ask if you stock “medical” marijuana? How many of you have had said douchebag argue with you when you say that marijuana is illegal to have on the basis of “I have a prescription”.
Let me clear the air here. Marijuana is a C-I substance. It is illegal. End of story. Cocaine is a C-II substance, cocaine is legal with an Rx!
I don’t care if you have an Rx from some quack in some hippie-dirt-eating-town like San Francisco or Seattle. I don’t care if you have a letter from God himself saying “Thou Shalt Smoke The Weed”. Its fucking illegal. Let me repeat it again because you were baked the first time I said it; its fucking illegal. Don’t care what your city says, what your county says, what your liberal fruity-motherfucker mayor says, its illegal. State law cannot relax a federal law, get used to it.
Where do people get off arguing with me about this shit? I could care less if there is a clinic down the road that sells it for “medical purposes”. A quick call to the DEA and that clinic wont be around for much longer, why? ITS FUCKING ILLEGAL TO GROW OR SELL MARIJUANA! Is prostitution legal for people with erectile dysfunction (with an Rx of course)? Think about that one for a while.
Now I know that people are going to blow me shit about how you have “glaucoma”,”wasting”, “blah blah chronic pain”, “blah blah you dont know how it feels” that require smoking out three times a day. My response? There are a whole shitpot full of other agents out there that are safer, cheaper, and work a whole lot better than smoking out. Stop using those lame ass cop-out excuses and stop inviting me to your pity party. Go see a “real” doctor and get a “real” Rx for some Soma or Vicodin instead of going to a quack and getting an “Rx” for some pot. I may not know how it feels to need pot, but you obviously don’t know how it feels to be annoyed while you’re trying to work (you know, work? The thing you don’t do. A job? Ring any bells?)
When you’re 24 years old, reek of pot walking in the front door, then stumble over your words saying that you have glaucoma and HIV/AIDS wasting (when you’re a good 260lbs) and you need some marijuana, it makes me want to kick you in the face and give you a real reason to smoke out everyday. Then you hand me your medicaid card which really makes me mad that you’re doing this shit on my tax dime!
And for god sakes, quit arguing with us about the legality of it! You’re a stoner hippie (still living with your mother) arguing with someone who’s not baked, went to college, has use of most of his brain still, can remember things for longer than 3 mins, and legally deals drugs for a living! In fact, you wont remember this conversation 10 min’s from now (but your glaucoma will be excellent!).
God help us if they decide to make pot legal. If you think Americans are fat and lazy now, imagine when a good majority of the population is sitting around eating Big Macs and smoking out all day. Oh wait, thats our welfare system. Sorry about that.
Currently the only way that us pharmacists get paid in a retail setting is by filling a prescription. The store makes zero dollars directly on phone calls, walk-in advice, or anything other than filling a prescription. Now I realize that being nice and giving advice = more patient support = more Rx’s for that patient filled at your store vs other stores = more money in your pocket. However, taking that phone call to help Ms. Jones find out what white pill is her lasix = 5 less Rx’s you can fill/day = less money made vs if Ms. Jones had not called.
So we already are giving away a valuable service for free rather than just machine-gunning Rx’s out and making the store some money. Here is where the insurance companies take a good natured thing that we do for society, and bend us over for it. Medicare Part D is forcing many of the smaller independents out of business. AWP-95% + 0.01 (here is your 1 cent dispensing fee, just hand the pills out in ziplock baggies with the drug/patient name written in sharpie on the outside).
So, stuck in a clusterfuck between the Insurance companies and being the most benefit to society, we have painted ourselves in quite a corner. Our choices?
Pretty screwed arent we? But alas, here is the kicker:
Insurance companies are the cause of this. They are the driving factor in why we need to hammer out at least X Rx’s a day to break even (but cutting reimbursement rates). However by making us do this, they are increasing the chance of medication errors which will land their patients in the hospital costing them /more/ money in the long-run. So they force us to fill more Rx’s per day with less staff, yet they gladly pay out the ass when we fuck up and someone lands in the hospital! Ingenious!
So how do we fix this? Obviously the insurance companies are reporting record high profits year after year, so the answer isn’t to increase our reimbursements. Medicare part D has that patient care thingy (where they pay us like $65 bucks for an hour of consultation or something like that). But if you get a net profit of $10/Rx (HAHAHA! Quit laughing you guys!!) you can do at least 20 Rx’s an hour and make more than that. Plus you have a set amount of time to bill for the Medicare part D consulting before it sunsets and you cant get anything. Not to mention its probably paper-billed and not online billing.
Answer? We’re screwed. Plain and simple. Short of selling the narcs out of the back door (or not taking any insurances and just charge patients your usual&customary) we will never truly be paid for our time and knowledge.
I’ve seem to have made a few doctors upset with my last few posts. I want to help clear up some confusion about this blog, and other items of interest. I type at over 40 wpm, so expect grammar and spelling errors (yes, i’m talking about you grammar nazis out there).
This list could go on and on and on. However:
So if I offended any doctors out there reading, my apologies. This blog is like going out for beers after work with your colleagues and bitching about what happened. I had a really angry response to a nasty comment (from a doctor) I received, but I think i’ll just sit on it for now.
Now approve my damn refill requests! Its been a week! 🙂
Quinine. Yes, quinine.
Turns out that the FDA is going to pull this oldie-but-goodie off of the market. Why you say?
Uh, hello? Quinine has been out since God was a boy. Its only been dispensed bazillions and bazillions of times to people for nocturnal leg cramps. Obviously it works. Do you see any published studies for aspirin? Of course not, but FDA wont get its panties in a bunch about that.
Deaths with quinine. Since 1969 guess how many deaths there were. 100? No, 1000? No, a billion? No! 93. Thats right, 93 people have died due to quinine since 1969. Hell, pull tylenol off of the market if you’re afraid of killing people. Aspirin has caused more deaths in its lifetime than any drug to this date. But no, the FDA needs to justify its existence by targeting quinine
FDA, if you’re reading this, get a fucking clue and quit getting sucked off by the drug companies. We’re onto your little scheme. It’ll go like this:
1. FDA pulls quinine due to lack of evidence of it working for leg cramps
2. Drug company X does some half-assed study showing it works better than placebo
3. FDA approves NewQuinine.
4. Drug company X charges $10/tablet vs $0.04/capsule for the old generic
6. America grabs their ankles.
The FDA is ran by a bunch of old doctors who haven’t practiced medicine for 30 years. They have no clue what the hell is going on and approves medications to whoever will give them a dollar and a reach-around. They’ll sit on tons of generics in the pipeline to be approved, but will pull a drug that has been around forever and is still in common use. They need to wake the fuck up. Yes, drugs have side effects. Yes, if you take 100 of drug X you will die. Doesnt mean pulling it off the market will fix it.
Or maybe we just need to slaughter all the lawyers. Hmmmmmmm….
This is going to be the last post about drugbuyers.com. I’m just going to point out a few points, paste a few hate mails, and leave it at that. I dont think drugbuyers.com administrators nor I want to deal with the aftermath of a full on flame war.
Here is where they say how much they love me
Points to make:
Enough Jerry Springer-like “Final Thoughts”. On with the hate mail!!!
Your a fucking dick…get your facts str8 or shut up bitch! You sure your
not a “junkie”? you seem to know soo much about DB.com and the people
there. Just to get your facts str8 (and you should know this) you cannot
get a schedule 2 med from an online or edoctor
I can spell ‘straight’, so no, I am not a junkie. Yes, you cannot get C2 narcotics online. However if you had enough brainpower to read the main page of drugbuyers.com, it does in fact say:
Where are the best sources for hydrocodone, oxycodone, and other strong pain meds?
Im sure the answer to this question would be “A Pharmacy”, but im sure it goes a little deeper than that.
I sure hope that you never cir cum to a debilitating disease.
You seem to be quick to give out your advice but, in reality you have no
idea. Just remember what goes around comes around and Karma (Whether you
believe in it or not) is a bitch.
In other words, if you keep up your shitty and piss poor attitude toward
your fellow man, Then I have no doubt you will end up disabled and alone.
Seems a fitting end to someone of your stature
Cir cum? Woah! I have enough positive karma to forgive Saddam, Hitler, and the DrugNazi. I bail people out of jams day in and day out. I advance people medication at no cost to them to keep them out of the hospital because their doctor took a week to okay the refill request. People love me at work, and I use this site to blow off steam at my fellow man. I keep my fellow man alive because he is too ignorant to call in for a refill a few days early vs a day after he’s out when the bottle states 0 refills remaining.
Oh, and since I fully suspect you don�t have the guts to post any negative feedback on your site, I�ve taken the liberty of posting your little screed on alt.support.chronic-pain newsgroup along with my response.
Thats great. Most of those patients probably go to a legit doctor, and get pain medications from reputable sources. Im sure a good majority of them would agree with what im saying, since this online doctor/pharmacy shit just supports the passing of stricter laws that make it harder for them to get the pain medication that they need. So I hate to say it, but your little plan to get angry mobs of chronic pain people after me might backfire.
“…who else buys their fucking pain medications from an “online” doctor and an “online” pharmacy”
How about chronic pain patients who can’t get adequate pain relief because their doctors are either chickenshits or selfish pricks. Many, if not most of the people who frequent drugbuyers.com suffer from chronic pain. If you read some of the discussions you’d know that.
The American Pain Foundation estimates that 50 million U.S. citizens suffer from significant pain daily, but only about a quarter of them are getting adequate treatment.
That’s because the DEA campaign against prescription drug diversion has stigmatized patients in need of pain medication. DEA intimidation tactics against doctors have created a climate of fear, with the predictable result that many doctors now won’t prescribe opiates at all or are only willing to prescribe amounts that are totally inadequate. The DEA is killing chronic pain patients by intimidating their doctors. Many more people die from not having the prescription pain medications they need, than die from the drug abuse the government is trying to prevent.
One of the major causes of those deaths is the overuse of OTC NSAIDS like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) by people who are desperate for pain relief. The Food and Drug Administration estimates that 200,000 cases of gastric bleeding occur each year, resulting in nearly 20,000 deaths.
Read more at deasucks.com
If you are in true chronic pain, and your doctor wont prescribe you anything stronger than Vicodin ES, then you need to find a doctor that knows something about medicine. Plain and simple. Skirting a gray-area of the law with an online doctor and online pharmacy is not only going to force more laws to be passed to limit narcotics (via your beloved DEA), but in the end result going to harm more people who are in chronic pain. So by going to these online joints you’re shitting in your own bed.
But what do I know? I only spend 8 hours a day, 5 days a week calculating how long a 30 day supply of soma (90 divided by 3 is a long lost art) will last to the same person every day (because they dont remember they called) , and hearing excuse after excuse after excuse on why they need their pain pills early (none of which are ‘they arent helping’ and they never seem to lose their BP/DM meds). Oh, and its never for the C2 narcotics either, because they cant be troubled to go into the doctors office for a new handwritten Rx. Yes, these doctors do write for C2’s. Yes, these same doctors do have chronic pain patients who are on C2’s, have a good quality of life, and who are never early on their medications. Yes, there are pain management clinics and doctors who actually listen what I have to say because they know that I talk with the patient a whole lot more than they do.
So thats the end of it (I hope). I hope I made my point clear.
I figure that since I rag on everyone else on here, I mine as well post a dumbass move by yours truly.
A few days ago, during work, I decided to eat 5 soft tacos from Taco Bell. Now any pharmacist knows that lunch time is much like bathroom time; a race to finish the quickest. So I inhaled those 5 soft tacos, drank about half of my large drink, and went back to work.
About 2 hours later, I had the worst cramps on the planet. My intestines decided to make a run for the border. I was hoping to just rip a loud fart (AKA a tech call, because your tech always walks right behind you no matter how quietly you fart) and be done with it.
No way, Taco Bell wasnt going without a fight. I try to go #2 in the bathroom, no go. The cramps were getting worse and worse. So I did the most drastic thing i’ve ever done in my life.
I grabbed a bottle of magnesium citrate and put it in the freezer.
Now I can see all of you retail people laughing hysterically. For those of you not in retail, Mag Citrate is what people use to clean themselves out. It usually comes in a small 10oz green bottle with a twist off lid. It comes in Lemon and Cherry flavor, but they both taste like ass. They usually produce a very explosive bowel movement. I’m not talking about soft-serve ice-cream poo, i’m talking about firehose KERPOW slop-dumping-in-toliet poo. The stuff that you dont want to do in a public restroom, because everyone present starts to giggle.
Ever play with those water rockets when you were a kid? Yanno, you fill them up with water, put them on a little air pump, and put a couple dozen PSI into them? You know how the water shoots violently out as it propels itself into the air? Well imagine that coming out of your ass. Thats Mag Citrate.
Anyhoo, the cramps are coming in waves, and after trip 4 to the potty to try to go #2 I proceed with the Mag Citrate Challenge. I dont want to take it at work, because I dont want my staff (and the rest of the store) hearing me shooting a stream of ass-slop into the toliet. So I wait until I get home.
I get home, crack open the almost frozen bottle of mag-citrate, and give it the ole college chug-a-lug. I chase it with about 16 oz of water, and prepare to turn myself inside out.
4 hours pass, and my intestines are talking to me in chinese (or maybe korean). Then, without warning, all I could say was: ‘Oh My God’ as I ran down the hallway into the restroom with my pants around my ankles.
You know that rocket I was talking about earlier? Yeah, that was me. I could of pressure washed my car with the force of the liquid that shot out of my brown eye. My insides felt like they were deflating. At this point both of my legs had gone numb from the sitting, and my ass had a hickey on it. But no, it gets better.
Imagine now small but fierce pockets of air mixed in with all of the juice. Thats right, we dont need a clean toilet here! Lets just atomize everything coming out into a fine mist and get it all over everything!
I wont even go into how much toliet paper was used to clean up this mess. All I can say is that there are some sad hippies around these parts from all the trees I used to wipe my ass.
Yeah, that was my evening.
Taco Bell – 1
The Angry Pharmacist – 0
Jeezus H Christ ive been getting a lot of hate mail lately. Heres the latest from a real life doctor!
I am friends with a ton of doctors. Dont take this as me bashing all doctors. Seriously, there are tons of shitty pharmacists as well as shitty doctors out there. However when a doctor writes what he/she said below (for no reason really, I havent said anything about doctors in a while) you know I cant keep my mouth shut.. 🙂 Plus im really sick and tired of hearing that we’re “wanna be doctors” (which we arent)
You pharmacists are real jerks arent ya? First off….alot of people that
are on medicaid are not all on welfare. Most of those people are the ones
who have pre-existing conditions that can not get private insurance or
insurance through a job!
Uh, medicaid = state assistance = welfare. They may have a huge Share of Cost on their Medicaid, but its still state assistance. Plus I hope you realize that im not against /everyone/ who is on the state tit. I see plenty of people who this really does help, my response mostly was about women who want to get pregnant when they cant afford to take care of themselves.
For example…I have a patient who is type 1
diabetic who uses a insulin pump. I script my patient humalog…my patient
calls and tells me the pharmacy is wanting 90.00 per vial for her insulin
and it was going to cost her over 450.00 for her 5 vials to last her a
month. I tell her to contact her local medicaid office and see if they will
give her insurance. They did…that same day! This woman works, goes to
school and has children but with her other medical conditions and other
scripts I write for her there is no way in the world she would be able to
take care of her family if she is not taking good care of her diabetes.
Bad example Doc. Type-1 diabetes is not a pre-existing condition that insurance companies will reject one on. Lets elaborate a bit further.
So for you ignorant pharmacists who “wanted” or “wished” to be doctors and
couldnt be because you couldnt pass the tests, you need to shut the fuck up
about people who are on medicaid! Alot of people that are on medicaid need
to be on it in order to LIVE! You pharmacists think you are gods gift to
this earth all because you stand behind a counter and “play” doctor.
Great, way to go and posting this little vent where thousands of pharmacists are going to read. I hope you have a lot of space in your inbox. Lets get the primer going shall we?
Now you may be saying “I’m not like that”. You can paint us pharmacists with a broad brush, so I can paint you doctors with an equally broad brush.
So I have a fair right to bitch about Medicaid, because unlike you, I actually spend more than 5 mins hearing my patients bitch about early narcotic refills, and why they have to pay $3 on a $200 rx (because some drug rep told them that the new extended release cipro for $5/pill is better than the generic at $0.06/pill). They vent to me, not you. The come to me, not you.
99% of pharmacists can go on to medical school and become doctors (AKA: The Dark Side). But why don’t we? Because we fill a niche just like you and everyone else does in the healthcare industry. Why don’t you go to pharmacy school and become a pharmacist. Oh, right, pharmacology, the hardest class in medical school to pass (says 3 of my friends who are in fact in medical school right now).
So yes Dr, we are Gods gift to earth. You’re just bent out of shape that most patients will take our advice because you are too busy to speak with them.
So since the last week or so have pissed off a bunch of people, I have pulled some old not-so-angry posts from the unpublished archives of TAP for your viewing pleasure.
This isnt an angry post, but mostly out there for the students.
Here is some shit that i did when I was in pharmacy school (and out on rotations) that made life a bit more interesting.
Disability often begins on welfare then migrates to the longer term SSD. I know you dont know this since you have yet to walk yourself through it.
I never plan to walk through it. Plus, ask any pharmacist and you’ll find out that there are a shitpot more 25 year olds on SSD + Welfare than welfare alone.
Glad to see you looked up endo. Most doctors do know what it is, did you read they dont somewhere? The problem is getting diagnosed (surgery). As you can imagine, a woman going in with the symptoms of “pelvic pain” doesnt tend to raise a whole lot of red flags. Doctors often do nothing until one is totally disabled or infertile. But it is not because they dont know.
You saying that right there tells me that most doctors dont know what it is. If pelvic pain so bad that it makes one disabled, it tends to raise a red flag for something not normal. Chronic pelvic pain, or disabling pelvic pain isn’t normal. Obviously you and I have enough common sense to realize it, and we’re not “doctors”.
I think most any endo patient would agree with what I said to you. Point being, there could actually be a valid reason.
Lets say this was the case, it would probably be a hail mary as many women know after pregnancy things can get worse. But it all depends on what position a person is in at the time and how much education they have about it. Then it is personal choices which obviously are always up for disagreement.
Would be a pity if someone were to judge and make fun of someone in such a situation for choosing to try while they can with the hopes of it helping their condition as well as possible plans for hysterectomy afterwards to solve the problem completely allowing one to return to health.
However if you cannot take care of yourself (being on welfare) because of this. You are in no position to do a ‘hail-mary’ call as to if a child is going to fix you, or make you worse. Sure, having a child could magically fix you, but if it doesnt? Not only is your quality of life going to get worse because of your condition, but you are also bring a child into the world which you arent going to be able to take care off to the best of your ability because of a botched judgement call.
So you sit there, in disabling pain, watching your child grow up, unable to do anything or act as a ‘normal’ mother. You call this helping? I call it hell. I bet you like to sit there with a garden house in your hand as your house is burning down. Thats what it would feel like.
Sure you can have a hysterectomy afterwards and be done with the whole thing, but now not only do you have to be able to support yourself (you cant, you’re on welfare remember), but now a child. I’m in the camp that if you choose to reproduce, you best be financially and morally fit to raise that child to the best of your ability so it too can get a job, succeed at life, and not become a burden like most children seem to be now days.
If us (the taxpayers) are footing the bill for someones life, then I think we should be able to judge all we want. If she doesnt like it? Get off of welfare or dont have a child.
Let me spell this out for you
Hysterectomy is any womens best shot at ridding herself of endo, endo often causes infertility,
Pregnancy to have a much wanted child ->hysterectomy isnt as bad of a plan as
no hysterectomy/no hormones/hormone failure/surgery failures -> stay disabled for ten years until you cant have children anyways and then opt for the hysterectomy.
If you cant afford to have a child -> Dont have one
If you are unable to have a child due to a condition -> Dont have one
If you require outside medication to get pregnant -> Dont have one
If you have a good chance of not being able to have a child due to a condition, and having a hysterectomy would fix that problem rather than suffer for 10 years because you’re he-hawing thinking about reproducing (which you probably couldnt anyways) -> Have hysterectomy
Its simple. If you cannot afford something, you dont buy or obtain it. Its like being on welfare and driving escalades.. wait, bad analogy. 🙂
Im glad this gave your blog some more fodder, surely it will entertain someone.
Self proclaimed nurse.
Actually everyone is quite bored with this already.