Ive been asked on more than one occasion (by MDs), why the ‘Angry Doctors’ on Twitter have such a strong Pharmacist following. Since I have undertaken the task of being the official spokesperson of Pharmacy on twitter, I decided to turn this answer into a well though out response vs a 120 character tweet.
If you’re looking for profanity, slurs against the downtrodden, just skip over this whole post. This is a post to generate discussion about a real issue that us retail Pharmacists have with our MD counterparts. Yes yes, I know that the past few posts I have been quite uppity and boring about some issues going around, but fear not, the poop-talk is coming.
What I shall grace before you is from my own experiences only. Although I represent a voice of pharmacy, I cannot speak for every pharmacist (although I do damn near get all of them to agree with me). I want the MD’s in the audience to think about this article, because its not meant to inflict harm, just bring to light exactly how us in retail feel we are perceived by you.
- Whenever we call for a clarification, you are “in the room with a patient”. We are unable to speak with you directly. Even if its about issues that can get you in serious trouble, like forgeries/stolen pads or narcotic shoppers. We speak with your “nurse” who gives the message to you. While we are waiting for your “Nurse” we have a line out the door and the hospital on the other line calling in discharge medications, yet we patiently wait. Your “Nurse” then gives us a response which is totally different than the original question, obviously there was a miscommunication between us and your translator which wastes both of our time. We feel that your time is worth FAR FAR greater than ours since you can’t spare 30 seconds to have a conversation with us even though we are treating the same patient. We feel like our concerns about OUR patients (which if we are calling you, its a concern, we dont have time to just piss away) take a backseat to everything else in your office.
- On your answering machine or answering service, you give a option for doctors or hospitals to get an express route to you. Yet you do not give pharmacists an option. Since we respect you (and aren’t a hospital or doctor), we are thrown into the call pool with your patients to be answered by a staff, who transfers to another staff, to transfers us to your nurses voicemail box, all while your patient is feeling ill and just wants to get the antibiotics (thats not covered) and go home. All of our IVR systems give you an express hotline to us, yet the courtesy is not returned.
- When we see you at the CE dinners, we introduce ourselves only to be shunned by you chatting with your MD friends. When you do actually talk to us, you don’t ask us how we’re doing; you ask us to pass the wine, or to fetch you something. We introduce you to our fellow pharmacists, yet you dont even extent the common courtesy to introduce us to the other doctors. We treat the same patients, we are on the same team.
- When is the last time you spoke with a pharmacist that you do a lot of business with. Not just call in prescriptions or yell, but actually ask how they are doing. Have you ever offered to have a cocktail after work with them? We would gladly treat you to cocktails after work, yet we never get the chance to speak with you to extend the offer. Do you even know what their name is? I guarantee that your local pharmacist knows what your first name is, shouldn’t you respect him/her and do the same? You do treat the same patients.
- Pharmacists, on the other hand, talk to each other. We ask how we are doing when giving transfers. We go out for cocktails after work. We warn each other about forgeries. Even ones who are in direct competition have a fraternal-like bond regarding reimbursement rates and looking out for each other.
- Pharmacists have a closer relationship with your front end staff than we do the MD that employs them. We know your nurses, they know us. We laugh and crack snide jokes about our patients who want yet another refill for that prometh w/ codeine.
Notice a trend here? Retail pharmacists get scooted to the side by MD’s in all aspects of our job. Now compare this with the angry doctors on twitter, who openly joke, converse, and treat pharmacists there as equals. Do you see why they have such a huge following? Do you see WHY pharmacist jumped to the defense of a faceless, nameless anesthesiologist who was bullied by an MD who seems like he fits the above description? The doctors on twitter are the doctors that pharmacist love. They don’t put us on hold or communicate to us via a 3rd party, they speak directly to us. They are approachable and friendly. I can send one a message and not wonder if they will ever get back to me because they will. I don’t need to watch what I say around them for fear of getting the “oh he’s just a pharmacist” eye-roll and subsequent ignoring. They are people, real people, like us. If you, the stereotypical MD, treat a fellow professional like us this way, how are you treating your patients?
I regularly go drinking with a NP and an MD friend of mine from a hospital nearby, and we discussed this whole issue about retail pharmacy and the local docs. They, working in solely a hospital setting, had no idea that this huge gap between us existed. They thought that all the docs in the area called up their local pharmacist and ask questions as basic as whats covered, to a suggestion for suitable beta-blocker for a patient with a low CrCl. They wondered how you can practice medicine safely without asking advice from someone who is knowledgeable about medication.
I find it interesting, that pharmacists; most if not all have doctorates, who went to school, studied, and work with drugs for a living, are ignored in general by your average MD (except when the patient bitches the “pharmacy wouldn’t fill what you wrote”, only to be yelled at by the MD because the drug wasn’t covered and costs $400). We are on the opposite side of the same coin, and ultimately the person who suffers the most is the person who is generating the revenue so we both can eat.
Part of this is the fault of pharmacists in general. Most of us really don’t have the time/balls to stand up for ourselves when push comes to shove regarding MD’s and medication therapies. We have allowed ourselves to be walked upon for decades. Ask a pharmacist who graduated in the 70’s what doctors were like back then (shout the orders, slam down the phone, “just fill the fucking prescription”). However the tides are turning. Residents are being taught to ask us for advice. There are too many drugs and conditions now for one profession to master every small aspect of both fields.
I’m really not bitching per-se, just letting you all know what your image is like on the other side of the fence. Do I expect this to magically change with one blog post? No. Behavior that has been refined over the past 100 years can’t change overnight. I hope this brings some insight on why the docs on twitter have such a strong pharmacy following.