Angry Tweets for 2011-01-05

  • Starting off the day singing the "Wrong Song" I have decided that I'm Dr Cox from scrubs today. #
  • My tech-student told me "Glad you didnt pull any punches yesterday with me". I treated her with kid gloves (which are now OFF!). #
  • Why do reps even visit us? We cant do shit and we sure as hell aren't going to suggest a new trade-name drug. #
  • I just heard out front "I had an written Rx but I lost it". I guess the term "Shit out of luck" is applicable here. #
  • How amazingly awesome (and dysfunctional) to have a hospital ran/staffed by the dr/nurses/pharm staff on twitter? Make it a TV show? #
  • Ive decided that I need to make more real-life pharmacy/doctor friends. #
  • Now all I need to make my Twitter-ran hospital a reality is an infinate sum of money to pay all you greedy bastards! #
  • And I also need the ability to spell infinite. #
  • Another 1000 today. Less busy but more trainwrecks/fires/ungrateful asshat patients #
  • Fuck. Its only tuesday and there isn't enough booze in the world that can make this week go smoothly. #
  • Im always nervous about my new website posts as I sorta care what people are going to say. I should get over that. #

Most trusted? Since when?

Everyone has heard that Pharmacists are one of the most “trusted” professions.  Sure nurses yanked that out from under us a number of years ago, but the fact that we are still on the “trusted” scoreboard started to make me wonder what exactly about what we do makes us so “trusted”?

Patients dont trust us.  They yell at us over their copays thinking that we are making a HUGE profit from that measly $50 copay when in fact we are barely breaking even.  They whine and bitch and think we are lying to them when we say that their pain pills are too early.  How many times have we caught a possible serious interaction only to have the patient demand that we fill it anyways because they don’t wish to wait the extra day for us to confer with their doctor (then transfer it out when we refuse)?  How many of us have suggested an OTC product only to have the patient pick the one with the shiny packaging that won’t do a damn thing for them (but Airbone was created by a SCHOOL TEACHER!).  How many times have you told mothers they cannot use a decongestant elixir on their 2 month old baby only to have them grab it after your back is turned?  How many times have we given them medications so they won’t have to sit in the ER only to have all of their Rx’s transferred to a chain for the coupons/gift certificates the very next day?  Someone who is “trusted” doesn’t get yelled at for non-covered drugs or for insurance-company doughnut holes, they should accept what we say (its not like we do this for a living or anything) and go on their way.  How many times have you seen a patient dump all of their pills right there on the counter only to count them (and proceed to dump them on the floor and demand new ones).  How many times has your drug knowledge been called into question because of “my friend said” or “I read on the internet”?  I guess we are trusted enough to know what isle the paper towels are on or to count the blue Lortabs vs the pink ones.

Doctors dont trust us.  95% of them won’t allow us to switch to a covered drug in the same class without going through 10 fax backs that involves their non-medically trained front end staff relaying incorrect messages and completely wrong information.  They dont ever get on the phone to speak to us because they are “too-busy” seeing patients and cant spare the 10 min’s to discuss an interaction that may kill someone (yet they take an hour lunch break every day.  When is the last time YOU got an hour lunch break?)  Yeah, sure they may be “reviewing paperwork” during that hour, but how many times have you gotten mindless “OK’s” when a valid question is written on the refill request in black sharpie?  How many doctors will allow you to use your knowledge over being their human shield/proxy when they piss a patient off?  How many doctors will stand with you against narcotic diversion rather than just rolling over and demand we fill narcs early when the patient starts to whine?  How many times have you gotten a call from a doctor wanting to discuss the narcotic use of a patient and what WE can do to help the patient (I can count the number of times this has happened on one hand, minus a few fingers)  Yeah yeah, doctors are busy, excuse me while I take care of your patient’s issue while I fill the other 1000 Rx’s that your other patients are screaming at me about because they aren’t ready 30 seconds after they call them in.

Insurance companies don’t trust us.  They make us go through mindless audits where they nit-pick /everything/ just so they can yank that drug cost right out of our checks.  We cannot call them for a prior auth even though we have a complete Rx history for the last 10 years AND have doctorates of pharmacy (or 20+ experience in the field) but rather hear some high-school dropout or some community college graduate tell them the exact same information read from a chart.  Our services and education are worth a dispensing fee that is less than the pizza boy who delivers in 30 mins or less.

State Boards/FDA don’t trust us.  They are the first to nail us to the cross and pull our ticket at the slightest word that someone has gone wrong.  They won’t stand up for us against the PBM’s even though THEIR fate is directly tied with ours.  Ever been inspected by the state board?  Ever gotten some minor-ass infraction just because they needed SOMETHING to ding us on to justify their jobs?  “Your fridge is 1 degree above the USP published standard, ignore the fact that I had the door open for the last 5 min’s looking for outdated insulin”.  They make us cram so much information on our Rx labels that it takes a masters degree to sort through all the tiny (and BIG) print to find when a drug was last filled.  We have to hand out STUPID medguides (more on this on another post) that list every side effect known to man that just scare the patient into not taking the drug.  To hell with actually US TELLING them what they need to know!

In fact, the only people who trust pharmacists are other pharmacists SOLELY because we are in the same trench.  Sure patients that you KNOW and have cared for will trust you, but its mostly out of professional friendship gained via feats that you have gone completely out of your way to do for THEM (illegally most likely) vs the inherit trust earned through a pharmacy degree and license.  Oh, don’t piss them off or they will drop you in a hot second for that chain giving out coupons and gift cards.

Not to belittle or devalue the hard work that nurses do, but what do they do that makes them number one in the “trusted” list?  The ones I know follow the doctors orders and care for them while they are in the hospital.  Their “trustworthiness” is not plugging the wrong IV (that has been scanned 100 times through a bar-code system and prepared BY A PHARMACIST) into the IV tube.  They make the patient comfortable and act as proxies to the doctors (the times that I or my family have been hospitalized this is what I’ve seen.  Sure its important, but #1 on the trusted list).  Dont we do the exact same thing?  I mean really, in a hospital setting you’re at the mercy of the nurse since you obviously cant walk around shouting and demanding stuff like they do when they walk into a pharmacy.  Nurses have a little light and call button to summon them, we have a phone and a pissed off patient storming in through the front doors demanding to know why their copays are “so high this month” (when they paid the SAME last month).

Pharmacists are like the kickers of a football team, we either save the day in a pinch or cost the team the game; in both cases we obviously didn’t win/lose fast or cheap enough.  Our shit doesn’t smell better or worse than ANYONE in medicine, yet we’re the human shield.

Oh hell, what do I know.  I just put vicodin and soma in little bottles not fast enough to keep the unwashed masses from bitching and moaning.  Yeah yeah, it’ll be ready in 10, your ride is impatient.

Angry Tweets for 2011-01-01

  • Been here for 5 min's and already filled 500 vicodin ES. Today is going to be rough. #
  • I have my wood-chipper all gas and lubed up ready for the new year! #
  • I resolve to be less of an asshole in 2011………. BWAHAHAHAHAHAHAHA!!! YEAH RIGHT!! #
  • Now what CYP150 inhibitor can I take to prolong my drunkness tonight #SUPA NERD #
  • Hi keypad! Please move the 1 away from the 4! CYP450! #
  • Im suprised that @pharmtech96 only has 100 followers. Shes angry enough to be my tech. #
  • "Nurse" called in 20 meds, then wanted me to read them all back to her. Yeah, right, just fax me the discharge sheet and be done with it. #
  • Walgreens gets the prize for the "Hold Time Leader" #
  • Hey fucktard, the radio is for OUR listening, not for YOUR personal American Idol. #
  • I should get "You graduated from a tech school, you should know this" on an auto-repeating boombox. I say it 10 times a day. #
  • Oh, he was #1 in his class too. #
  • I love how tech schools say they are doing us a favor by giving us "free externs" that we need to babysit. #
  • Hey WAG, where are my fucking copies? Oh? You're busy? Well your staffing is not my fucking problem. #
  • To all the new peeps following me: Congratulations! You're about to see how much pharmacy blows donkey dick! #
  • Off to one of many parties. So dont feel like going out tonight. Happy new year everyone! May your viagra last less than 4 hours! #
  • 80mg of Pepcid and 8mg of Zofran on-board. Time to rock and roll. #
  • Party time halted. Cannot find shoes. #
  • Also cannot find suture kit and med bag. No point in going to the ER tonight since they will be SWAMPED. I go to rockin parties 🙂 #