Uh oh, I made a doctor angry!

Jeezus H Christ ive been getting a lot of hate mail lately. Heres the latest from a real life doctor!
***NOTE***
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.. πŸ™‚ 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.

  • I realize that this example is someone who is using the system for what its intended for.
  • You dont realize (because you never leave the comfort of your little protected office) that there are 25 year olds on the system who dont work, who sit around pop out kids, and will never do anything with their lives. Thats who I have a beef with.
  • What does this hate mail have to do with anything ive written? It was in response to a bitch that women on welfare should not have children. I think thats a pretty good common sense idea.
  • Where did this patient get the insulin pump for the Humalog? They don’t just grow on trees. How did she afford this? Why would a person get setup with a specialized piece of equipment (insulin pumps are indeed specialized) when they cannot afford the maintenance cost? Looks like bad foresight on someones part. Humulin R, N, 70/30 have been the mainstay for years and years, so why go with the latest and greatest. Oh, a drug rep told you.
  • Humalog does in fact cost $90. Not the pharmacies fault. Im sure you don’t work for free, so why do you expect us and the drug manufacturers to do the same?
  • I don’t see you putting out the $90 for this patients insulin. Why don’t you sweet talk the rep into getting some samples to give to your patient.

    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?

  • We bail your ass out when there are 3 specialists all writing for the same therapeutic class because you cant get off your high horse to talk with each other.
  • We talk to the patients for free because you cannot due to your patient load
  • We take the phone calls when your patient has a problem because you’re too ‘busy’ to talk with them
  • We get that $300 medication (that the drug rep told you was the magical cure-all) changed to something that the patient can actually afford (that has worked for the past 20 years, but for some reason doesnt work as well because its generic).
  • We don’t listen to drug reps who love to blow smoke up your ass, and you love every minute of it for the free schwag and the glimpse of fake boobs and a short skirt.
  • We don’t cave in because some crackhead needs his vicodin early for the 10th month in a row for some bullshit excuse even though you caved in and authorized the refill
  • We have to deal with the fallout of you not taking a patients insurance, and suggesting what doctor they go to for patient care.
  • We are your backbone and scapegoat. You blame us for everything so you don’t take the heat. How many times have you said “oh, talk to the pharmacist about that” because your little PDR didnt have information on drugs over 10 years old.
  • We keep your patients out of the hospital because you cant be troubled to approve that refill request until 10 days have passed and your patient is long out of medication.
  • You use the PDR for your drug information. Enough said. Any pharmacist will tell you that is the most horrible and shitty drug information book on the planet. Facts and Comparisons and LexiComp win hands down. Im sorry if the CYP450 system confuses you.
    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.

  • The Pharmacy Challenge

    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.

  • The Ambien Challenge: 2 guys take a 10mg of ambien, and the first one to fall asleep loses. I managed to win long enough for my legs to go numb, upon which i crawled to my bed. My victory dance involved only the top half of my body, and from what I can remember it looked like I won the special Olympics.
  • The MagCitrate Challenge: 2 guys, 2 bottles of MagCitrate, 1 toliet. Its a race, whoever can explode out of their ass first is the winner. Needless to say the urge for me to NOT shit my pants was my undoing. The secret is to chug the Mag Citrate, and lock yourself in the only restroom. Squirting butt-juice as you hunch over in the backyard bushes isn’t all that fun (especially after a few beers).
  • Wheelchair races: You haven’t worked odd-hours in a hospital until you have done wheelchair races against the medical residents. Due to the compound they use on the rear wheels for traction, I strongly recommend to NOT power-break the rear wheels to slide into that sharp turn. You’ll flip, trust me.
  • NS Fights: What do you do with old expired bags of Normal Saline? JUMP ON THEM IN THE PARKING LOT! They really explode quite nicely. You can also pin-prick a hole in them and spray your fellow interns. However doing so with D5W tends to make things a bit hard to clean up.
  • Monday Morning Flush: Make a few friends with the ER nursing staff or some medical residents who come early monday morning can load ya with a few liters of IV D5W after a hard weekend of drinking. Its magic I tell you, magic! If you open up a clinic that did nothing but this near a party-college and charged $50 a pop, you could make millions. If you totally do this I want a cut for coming up with the idea. You heard it first here!
  • Here we go again

    Angry noob,
    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.

    How about:
    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. πŸ™‚

    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.

    Drugbuyers.com? Gimme a Break.

    Turns out that the DrugMonkey and I are in a little bit of hot water at a popular addic..er..’drug information group’ message board as viewed Here
    Guess we’re too bitter for the peons who happen to frequent a message board dedicated to buying pain medication from online doctors. Gee, thats an ironic twist isnt it?
    From the site www.drugbuyers.com:

    Our goal is to help you locate the best legal sources for prescription drugs
    and to offer the best information about buying meds online.
    We offer a free site based on member feedback
    We can help you – We need your help
    Online Pharmacies, Online Doctors, and Referral Services
    US, Canadian & Foreign Pharmacies
    Best Pharmaceutical Sources
    Free Pharmacy Watch Group

    Plus my personal favorite:

    Where are the best sources for hydrocodone, oxycodone, and other strong pain meds?

    Enough said.
    Now I get plenty of hatemail from asshole druggies like these. Why do I call them asshole druggies? Because who else buys their fucking pain medications from an “online” doctor and an “online” pharmacy? I’ve seen terminal cancer patients able to see a doctor and have a family member pick up their pain meds for them. No excuse.
    I can see the doctor consulation IM dialog now:
    Druggie: I have back pain doctor
    Doctor: On a scale of 1 to 10, how bad is your pain?
    Druggie: 345!
    Doctor: Oh, that is bad. I think you should see someone local
    Druggie: I cant! My pain is toooooo bad!!!!@#!@
    (har har har, little does he know that i’ve been kicked out of every pharmacy/doctors office in town for early fills, harassment, and other shit that pharmacists bitch about)
    Doctor: Will I will give you some Vicodin and Soma.
    Druggie: That does not work! I need perc0cet and Diazep4m and S0m4 and V|agr@!!!
    Doctor: That’ll be $45, and go to this easy online pharmacy (who will ask you no questions, contain no history, and is ran in someones basement with diverted hospital stock) to get your drugs!!!
    Druggie: Thank you doctor! You are the most ethical, prestigious, and a pillar to your profession!
    Doctor: Yeah yeah, Credit Card Charged, NEXT!
    Oh, and whats even better, is that if you read the message thread they talk about diverting pain medication (the ones that fell on the floor) and who accounts for inventory. LOVELY! And these douches are giving the DrugNazi and I a bad time? Im surprised nobody has written a how-to on there about altering prescriptions.
    Now I know a good majority of you pharmacists out there just wanna go and blast them off of the internet. Now usually i’m all for skimming the turds that float to the top of society, but I must repeat what the DrugNazi said:

    Go over and read their board if you must, but please, don’t start a pointless flame war. I would much rather turn the wrath of the drugmonkey army loose on those that are truly evil, like Republicans. Remember these people are doing us a favor by getting their fix through the mail, as opposed to endangering our licenses with bullshit reasons why they need that early Soma refill.

    Yay! Someone who thinks they know something!

    Look what some smart-ass had to say in response to my entry about Welfare + Clomid = WTF?:

    Ever heard of endometriosis? No course not, youre not a doctor lol.

    Yes, I do know about endometriosis. I would explain it to you, but the words are too big for your tiny brain to comprehend. But to those out there, its a condition where uterine tissue grows in places that is not your uterine (in a really general nutshell)
    Actually, most all doctors with the exception of OB/GYN’s and maybe oncologists wouldn’t know what endometriosis is. So you can ‘lol’ that up your ass.

    If a girl had endo, which can be disabiling, I could see her point in
    trying. 1. sooner the better 2. pregnancy often kicks endos ass. Becoming
    pregnant used to be the main offerings for treatment but women who have
    been horribly disabled by endo changed that.

    What does this have anything to do with my post about people on welfare getting fertility drugs? In fact, this has nothing to do with the people wanting to have children when they cant even support themselves! Did you even read my rant before responding?
    Let me spell it out for you:
    I AM TALKING ABOUT WOMEN ON WELFARE WANTING FERTILITY DRUGS TO GET PREGNANT. I AM NOT TALKING ABOUT ALL WOMEN WANTING FERTILITY DRUGS, ONLY THE ONES THAT CANT AFFORD (meaning, they dont have the money) TO TAKE CARE OF THEMSELVES LET ALONE A CHILD. IT IS LIKE SELLING THE CAR FOR GAS MONEY.
    However, since you can spell endometriosis (and are probably a self-proclaimed “Nurse”), i’ll give this another 2 seconds of brainpower. According to the standard treatments, pregnancy isn’t even on that list. In fact, im sure most women would rather be on some sort of oral contraceptive rather than bare/raise a crotch-fruit for 9 months + 18 years. Furthermore, since 30-40% of these women are sterile, why would they be taking Clomid? Not going to do them one damn bit of good except to waste money. Nature has a funny way of saying “maybe you shouldn’t have kids”. I think some women need to read the writing on the wall rather than trying to override nature and get some horrible burden they may not expect.

    Anyways, mighty pharmacists dont know it all, which is why we have
    doctors.

    Uh, dig that hole a bit more sweety. I’m sure that there is a bit more you can do to completely make a total ass out of yourself.

    Welfare + Clomid = WTF?

    I got this comment from Sandi, and could not believe it:
    This patient takes the cake.
    I normally do a fair amount of grumbling over how much stuff is paid for by Medicaid, but this time I had to be proud of what was not covered…
    A lady came in with a prescription for Clomid. I did not ever in a million years expect she would be on Medicaid, so I had to look twice and still ask her if she had a new insurance card. Nope, she really is on Medicaid. Then she was just downright surprised that Medicaid would not pay to get her pregnant! Yeah, sure, why don’t you bring a few more into the world…on us. Not.

    For those at home: Clomid = Makes women have babies. Just don’t stand downwind of a guy, you might become his baby-momma.
    Sandi, you showed restraint unknown to those of us in retail. I personally would of called up the doctors office and asked them why they were writing a fertility drug to a patient that obviously could not take care of her self, but for some reason thought that bringing a child into the world would magically make her problems go away. What kind of dipshit retarded doctor would write for this? Oh, one of those “Everyone has a right to a family, blah blah blah”. Yeah, you pay for that fucking kid so we don’t have to.
    I would of just told her it wasn’t covered, and if she asked if I could call the doctor to get it changed or get a prior auth, I would just say “If you cant afford this medication, how can you afford a child?”. Tough questions, tough love, only here on the angrypharmacist.
    What i’m most surprised from this story, is that there really is an infertile welfare female out there. I thought that the cure all for infertility was to just go on welfare. In no time you’ll have one on each tit and another in the oven.
    Yes, i’m going to hell. Straight to hell.

    Lancet Devices, Free Copays, and Fatties on Ensure

    Whats the issue with people and keeping a loaded lancet device in their diabetic meter case. I mean its bad enough that I get handed this meter that looks like its been used as a tampon, but when I look at the lancet device (dont get me started) it has a friggin loaded lancet ready to go.
    Im sorry, but its bad enough that I need to touch your nasty ass meter, but leaving your lancet device loaded it just asking for trouble. What if I stick myself on it? Then what? Do you also keep loaded guns in your child’s bedroom? Do you drive drunk or under the influence of Soma or Vic-er.. never mind that part. The point is, when you bring in your meter to be looked at by me (who’s already swamped with work), PLEASE remove any uncapped lancets from your device. Whenever I get one (today I got 2), I always say “oh, thats nice, ready for me to stick myself on”. They don’t get it. Seriously, they just don’t fucking get it. Pisses me off to no end this does. What makes it even better? Is when they receive the meter from a mail order pharmacy and expect ME to show them how to use it. Fuckers, I wish i could kill them with my brainpower.
    Another thing. For some reason, Medicaid and Medicare people always seem to think that ANY copay is too much. You got $150 bucks worth of Levaquin for $3.10? Too much. $2000 worth of Epogen for $3.10? No way. It has to be fucking free. Im sorry Medicare reciepients, but its not MY fault that you didnt save your money when you were young. Cricket and the ant man. All of us working people are the ants, and your sorry ass are the Crickets. Winter is a coming.
    Also, Its not MY fault that i’m paying a good deal of my check into this ‘system’ for which I will never be able to draw a dime off of. Im sorry you’re poor and on a fixed income and forced to eat dog food. But yanno what? I gotta eat, I gotta pay my power bill too, and to hear you bitch about your $3.00 copay on your $2000 prescription really isn’t worth my time. In fact, its insulting, because 2 years ago you would of gotten NOTHING covered under MediCare part A and B. So QUIT FUCKING BITCHING and go watch Jag reruns.
    Now, heres the best of them all. Why do MediCare/MediAid folk think they are entitled to Ensure? Why is it you NEVER see a private pay or someone with private insurance get an Rx for Ensure? For you at home, Ensure is one of those food replacement drinks that you take when you cant take solid food. Now I’ve gotten tons of prior auths for people with AIDS+HepC wasting, and throat cancer where they cant swallow, or people with GT Tubes. But when some fat son of a bitch waltz’s in with an Rx for Ensure because “I’m losing weight” I want to stab him and his doctor in the face with my pen. Does Medicare/aid pay for a loaf of bread? Can I bill /my/ lunches to /my/ insurance? NO! So why should Medicare/aid pay for your Ensure unless you have a good fucking reason to be on it?
    Seriously, I had to do a Prior Auth from (where else) the County Hospital for this patient who “hasnt eaten in 2 weeks”. I thought she was a chemo patient, or had some serious problems. She was out in the car, so I asked her “caretaker” (don’t get me started) for her to come in so I could ask her some questions for the PA. Well, she didn’t walk in, she waddled in. She wasn’t eating food for 2 weeks, she was eating bacon fat soaked twinkies for 2 weeks. I seriously turned to the other pharmacist behind me (and the techs) and gave the “What the FUCK” look. Immediately they retreated to the back room to laugh. This chick was large. She started into this sob story how she needed this because she didn’t eat for 2 weeks, blah blah blah, brain turned off. I seriously had to make a conscious effort to remove the “you have got to be fucking me” or “wheres the hidden cameras? This has to be a joke” look on my face. Did she just want Ensure so she didn’t have to raise the fucking BigMac to her fat face?
    So I get the info, and contact her doctor to find out exactly what the diagnosis and her latest BMI (Body Mass Index) was. The doctor called, and first thing after she gave some diagnosis about “not eating for 2 weeks” was “Have you seen the patient?”. Yeah, to make a long story short, when I submitted the Prior Auth I got a phone call from the insurance company asking me if maybe I transposed some numbers when writing down the BMI. I said no, and they promptly denied it with laughter in their voice.
    Oh, and if you think you can somehow convince me to feel sorry for this lady, please dont invite me to your pity party. You have no idea what she milks out of our tax dollars.