Category Archives: General Chatter

Back with a vengeance.. Well, not really.

So, here we are again.

Where as the mighty angry one been all these years?  I’ll be honest.  Life.  Thats right, fucking life.  Happens to the best of us boys and girls.  Get married, have kids, and suddenly you’re on statins, getting a colonoscopy, watching your pharmacy infamy die a horrible rotting death, and watching ‘my 600 lb life’ hating that fucking doctor’s gold stethoscope.

Well, that and I just didnt give a fuck anymore about the daily crackhead grind and idiot patients.  I had reached pharmacy-zen where every problem was no big deal.  I expected the early refill bitching and the stupid lost script song and dance.  I expected idiots to not understand they had a deductible first of the year (like the previous 5+ years that they magically ‘forgot’ about).  It’s hard to rant about shit when you expect it coming in the door for 10+ hours a day.

Plus the server the site was on was held together by duct-tape and bailing wire.  I was afraid to post for fear of the entire deck of cards falling down.   No really, it was a strong Go-Lytely fart away from exploding.

Not to mention (I absolutely hate this fucking part) that I had to watch what I post and couldn’t be as raw as I had in the past.  Yeah, censoring yourself sucks.  However since our president is 1000x worse than I am, fuck it trebek!

In other words I’m as full of excuses as your typical crackhead…. Only i’m not hounding you on the phone…. or staring at your face… or wishing you dead… or wanting a gallon of prometh with codeine for my ‘bronchitis’…  Ya’ll got the yellow norcos? I’ll pay cash!

HOWEVER!  That being said, after hearing the calls of help from you all, I dumped money into a server, got my shit together, got a new shitty site layout that will not be 100 years out of date, and decided to MAKE PHARMACY GREAT AGAIN (Okay, so maybe I wont make it ‘great’, I’ll just make it suck a whole lot less)!  Like motherfucking Batman coming out of retirement (actually I think im more of a Deadpool’ish sorta crazy).

Motherfucking #tapreturns (for the record, I fucking HATE hashtags.  Like really hate them.  Twitter ruined the internet.

Enough about my excuses! Here are some tidbits that are in the pipe for ranting:

  • eScripts and how much they make my life hell (complete with image examples of some whacky ones if I can figure out how to strip all the metadata out so people dont get in trouble with the HIPAA police)
  • Docs who take altered C2 Rx’s and say “Oh just fill it anyway”.  Yeah, what the fuck.
  • All the bullshit the DEA makes us do now for stupid Opoids + Soma + Benzos.  As if I did enough babysitting.
  • Just general fucking bitching about DIR fees and other insurance bullshit.

An Xmas poem that beats the shit out of mine

This is taken from Apothecary Tales.  Its too well written and too funny to have me just skip over it:

Twas the night before Christmas, when all through the house
All the crackheads were stirring, much like a crackhead mouse
The Promethazine poured, from the bottle with care
In hopes that St. Codeine, would bring plenty to share
The crackies then nestled while withdrawing in their beds
When visions of methadone danced in their heads
Mama in her mu mu and daddy in a wife beater
Just cooked up crystal meth on top of their heater
When from downstairs arose such a clatter
Daddy sprang from his bed to see what was the matter
Away to the stairs he ran like a cheetah
Fell over his pants and swallowed Viagra
The moon on the breast of the Kentucky Fried Chicken
Gave daddy the munchies as he entered the kitchen
When what to his wondering eye should appear
But a large ass bottle of Suboxone was near
With a little old taste, so delicious and quick
Dissolved under the tongue and downed with a drink
More rapid than acid, his prescriptions then came
And we he whistled and shouted, and called them by name;
Now Valtrex! Now Soma! Now Focalin and Concerta!
On Oxys! On Percs! On, Valium and Xanax!
From the top of the window to the top of the wall
Get me high, get me high, get me high y’all!
As colors before the wild hallucinations occur
Daddy’s body convulses before it hits the floor
So up then gets mommy and grabs and Epi-pen
In order to revive daddy to play with St. Codeine again
And then in a twinkling, they heard at the door
Some neighbors came over, looking to score
Daddy got dressed in a coat made of fur
Got the Purple Drank ready and danced on the floor
A bundle of narcotics daddy had flung on his table
Snorting the Oxy’s, all were willing and able
His eyes, how they glazed over!
His dimples how merry!
His pupils rolled to the back of his head, shit just got heavy!
His drool from his mouth was foaming like a dog
And the beard on his chin was getting all clogged
The stump of a crack pipe he held in his teeth
And the pattern of piss circled his pants like a wreath
He had a pale face, used to have a lead belly
Which now caused his coma and made him poop out brown jelly
He was skinny and dirty, a right scummy-ass dude
Everyone laughed when they saw him, smelly with an attitude
A twitch in his eye and turn of his head
His tongue flopped on out, we all knew he was dead
He spoke not a word, but there was still a party to go
It was mommy’s turn to snort, this time some blow
And laying a finger on the side of her nose
Line up another one bitches, I’m now a single ho!
She sprang to her feet and gave her husband a look
Then thought of all the drugs she still had to cook.
But I heard her exclaim, as she snuck out of sight
Merry Christmas motherfuckers I’m getting my “OC’s” on tonight!

The Angry Pharmacist Socalized Health Plan Solution

Here is my outline as to what could be the perfect socalized will-fail-less government subsidized medicine plan.  Since obviously this is going to be passed riding on the coattails of the H1N1 fear and panic machine, I could at least throw in my $0.02 as to how this is to be laid out.

Now before you read this, remember years past when WalMart came into town?  How they used their huge might to pretty much crush any competition in the area with “low low prices” all while shitting on their employees and being an all-around shitty store with poor service.  Now considering this government plan has the financial backing of every taxpaying man and woman in the nation (regardless if they want to or not); think of Walmart as your cushy retirement insurance plan goes bankrupt and you’re forced to enroll into a government ran plan.

The Angry Pharmacist Socialized Health Plan Solution

By: The Angry Pharmacist

http://www.theangrypharmacist.com

Here are some nice and easy (and unrealistic) points that this new government funded (with freshly printed money/stolen from the working class) health plan should have:

  • No trade name drugs are covered.  No exceptions.  Prilosec/Protonix doesn’t work for you? Tough shit.  Cough with ARB? Too bad.  None of the trade name medications would be covered.  The government needs to eat its own dogfood (or practice what it preaches) and only does business with companies that drive down the cost of medication (ie: generic companies).  That expensive chemo drug not covered? Then let the government use taxpayer dollars to buy out Amgen so they can give it out for free (why not, everyone else got bailed out).
  • The plan is voluntary.  If you wish to be a part of Obamacare, then you get the premiums deducted out of your gross-pay.  If you wish to have private health care, then you won’t be dinged a dime for Obamacare.  I’m not paying for all of your PacifiCare and Blue Cross plans (and your insurance premium dollars dont pay for my private insurance) so why should I have to pay for someones Obamacare?  The chances of this happening are as likely as you buying the nice bridge I have for sale.
  • You get 4 doctors visits a year with no/low copay (say, $10).  Every doctors visit after that has a $25-50 copay.  Yeah, it sucks for the people with chronic conditions like diabetes and stuff, but its better than nothing.  Don’t get the unlimited text messaging plan and you can afford your doctors visits.  Don’t order a large pizza and you can afford another doctors visit.  Wait, actually becoming an active part in my health? What is this witchcraft you speak of!
  • You get 1 $0 copay ER room a year.  Every ER visit after that is $100 minimum.  I’d like to see this figure raised to $250 or higher since ER is for……. EMERGENCIES!  You know why the ER rooms are so packed? People view them as “Free”.
  • Since all Rx’s will be billed to the government, if you are on a maintenance medication and you are non-compliant, guess what, your premiums just went up unless YOU (not your doctor, not your pharmacy) can submit documentation showing that you were taken off of that drug, or switched to another one due to intolerance.  Whats the point of the government dumping all this cash into your doctors visits and medications if YOU are TOO LAZY to do anything about YOUR CONDITION.  Not taking your medication is just pissing away money.  No matter how many times I bitch, your doctor bitches if you don’t want to take your medicine then you can get dinged in the pocketbook.  True this can be thwarted by people just picking up their regular drugs and not taking them, but it might make a few people think twice before asking for medication they have no intention of taking.  Cue the “Waah, we don’t want the government poking its nose into our lives” as they happily promote Obamacare.  Wait, are you confused?
  • If your doctor kept up to the standard of care, then unless his peers can show an act of negligence, you cannot sue him/her for 1.4 zillion dollars in a huge malpractice suit.  Lets face it, without your doctors care, you would have died a long time ago.  We don’t need your doctor running up the bill with 400 lab tests every damn office visit out of fear of getting sued if he/she happened to miss something weird.

Now on the surface, this plan looks pretty damn shitty.  However we have a fundamental problem in this country where we want privatized health-care at socialized prices (ie: Free).  Not going to happen, actually it can’t happen!  Look at MediCare and how broke it’s becoming!  No seniors bitch about Medicare (doughnut hole), because they are so (doughnut hole) happy about the coverage (doughnut hole) that it provides (doughnut hole).  Did I mention that the government had to implement the doughnut hole to keep the Medicare system from going completely broke?  Did I also mention that we just slapped Rx drug benefits on top of an already stressed system like an idiot taking a 4th mortgage out on his house to buy a boat then wondering why he can’t make the payments.  Should I just ignore the point that before Medicare part D came out, seniors on MediCare were paying cash-money for ALL of their medications and were doing just fine on all generics?  It wasn’t until the government decided to “feel sorry for them” and slap on a part-D plan that they became greedy and wanted trade name shit (all for no copays).

If health plans were cars, this would be the basement model with no A/C, manual transmission, manual windows/door locks, and it pretty much just gets you where you need to go.  This would be the ideal solution.  It gives people the basic care they need, and to be honest if they wished for a plan with more bells and whistles then some most-costly private plans could do them well.

Oh, but wait, we all want our cake and eat it too.  Mark my words, this plan will give people an inch when they want a mile, and short of the entire collapse of the healthcare system, the public will just want MORE for LESS.

I’d like my bailout in 20’s please.

The Joys of Social Workers

In this world, there are two types of social workers:

  • The ones you never see or hear about.  The one that the patient calls and they get the shit done fast.  The only time you actually speak with them is a 5 second phone call with an ID/Group/etc number and a “did it work?”.  Pharmacists love these kind of social workers.
  • The social workers that are not like the above group which I will elaborate below.

Every profession has its fair share of idiots.  There are idiot pharmacists, idiot doctors, idiot bus drivers and idiot ditch diggers.  The only exception to this rule is patients, which they are all idiots. 🙂

However social workers seem to collect and concentrate the “duh”.  The social workers that make their presence known to pharmacists turn out to be the most incompetent, inept, and whiny people on the planet.  They are like like Steve Urkel (“Diiiiiiid I do that?”) of the health care world, out to do good, but end up pissing people off/making it worse in the end.  A whining contest between a crackhead and a social worker? I’ll let you guess who wins. Here is a conversation I had recently with a wonderful social worker:

SocialWorker: “Hi! I’m Billy and I’m a social worker”

TheAngryPharmacist: “Hi billy”

SW: “I got a call from John Smith who said that his Zyvox was not covered and he would have to pay for it”

TAP: “Yeah, his insurance doesn’t cover Zyvox withou-”

SW: “BUT HE IS ILL AND HE NEEDS THAT MEDICATION!”

TAP: *sigh*

SW: “HOW CAN WE GET HIM THE MEDICATION!”

TAP: “Uh, its well over a thousand dollars”

SW: “THAT IS HORRIBLE! HE NEEDS IT!”

I’m going to save you the whining that followed, because to be honest my brain had switched off at that point.  It just involved complaining about the price of Zyvox, how evil MediCal was (oh really?) and that the doctor should just be able to write for something and have it covered.  The whole concept of having a medical resident just write for Zyvox without trying anything else (or doing a C/S workup) completely eluded him.  Oh, and somehow it was /my/ fault that I wouldn’t give him the medicine for free.  Yeah, COMPLETE knowledge of how the system works.

Here is another gem:

SW: “Hi! Im Jane, the social worker for Billy Mays”

TAP: “Hi Jane”

SW: “Billy’s MediCal isn’t working, and he’s out of medication, what can we do for him”

TAP: “Well, he’s should only be out of Prevacid, he can go a day or two without it”

SW: “Well, can you fill the Rx, then call MediCal and find out when his coverage will be turned back on and bill it then?”

TAP: “Uh, no.”

SW: “Why not! HE NEEDS THE MEDICATION! HE IS IN PAIN!”

TAP: *sigh*

These two were in the span of about a week of each other. They were different social workers but I assume must either share the same lead-coated coffee cup or used the same lead-painted crib growing up.

Whenever a Medicare/Medical patient comes in and say “I spoke with my social worker about my MediCare Part D coverage” I want to bang my face against the counter.  99% of these cases end up in the patient not having coverage for a month (while one gets shut off, and the other starts the first of the following month) and suddenly it becomes my problem.  For someone who supposedly knows how the ‘system’ works, they sure manage to screw things up.

Like I said earlier, there are social workers out there who are completely ninjas and are awesome at what they do, however they never TALK TO ME!  Share your funny social worker story!

New backend, new layout, new beginning.

Many of you have emailed me asking why I have been so quiet the past month or so.  Well, now you know.

Welcome to the new Angry Pharmacist site!  Not having threaded comments (meaning you can reply to a comment, and your reply appears under theirs) really bugged me, and Moveable Type just wasn’t cutting the mustard.

So I found n6design and asked them for a new layout for WordPress.  They went all over town taking pictures of old stock bottles and tablets (I love the Viagra rocket, but the Soma balloon is the best) and even managed to take some pictures of an old Bates Stamping Machine.

The site otherwise should be the same.  Most of the old direct links should work, however I know of a few that are probably broken.  I’ll be adding more things (like twitter, can’t let DrugMonkey and TAestP get one up on me) as soon as I get most of the bugs worked out.

Site upgrades! Fun for everyone!

See, not only does the pharmacy piss me off, but computers piss me off as well.

All I tried to do was to upgrade the software that this system runs on.  You know, new version of Movable Type, tons of new features, shiny-shiny-oo-oo!

Yeah, I got it in the ass, big time.

If you received like a bunch of email from this site about old-as-hell entries, thats why.  I’m sorry (and thats the only time you’ll get a genuine Sorry from me) that the software that I tried to upgrade sucks.  Fortunately I managed to contain the 45,000 emails that were on their way out.

I’m trying to get account creation fixed so you can log-in and post to this site (without going through the "I’m not a spambot" human test with the funny writing)

Stay tuned for some awesome Medicare Part-D handouts that I’m making especially for your problem old-patients!

If you see something that is really broken, email druglord@theangrypharmacist.com and I’ll do my best to see whats going on.

Patients who kill your Patience

Retail pharmacy (or working with the public) demands one huge element that most students lack.  They don’t teach you this in school (although they should) nor do they even mention this anywhere in any textbook.  Its called patience, and as the day wears on my patience dwindles and dwindles.

However some of my patients act like patience sinks, quickly sapping me of my patience reserves and turning me into an angry, irritable asshole until the clock-out bell rings.  Since I haven’t done any sweeping stereotype posts in a while that piss people off, heres what you have been missing.

  • Old people.  Staring at you with those big empty eyes, you wonder what they received from of being alive for 75+ years.  They get confused /so/ fucking easily and make you explain things so many times you just wish they would go home and die.  The words “fixed income” somehow results in $1.05 being too expensive for their heart medicine as they smoke that $5 pack of camel filters outside of the store.  You honestly wish you could tell them “listen, you obviously aren’t mentally capable of taking care of your own medication, do you have anyone else that can help you?”.  Wait, Ms Smith is on the phone asking what “Once Daily” means again!
  • Mothers with misbehaving children.  If you had problems controlling one child, why on earth did you decide that having 2 or 3 more would be a good idea?  I used to warn the mothers when their children would scream out of the front door of the pharmacy while she’s looking at greeting cards or earrings.  Now I figure that once one gets hit by a car in the busy parking-lot she’ll learn to keep an eye on them.  Yeah, I’m a dick, but after warning them time after time to control their kids, you figure that maybe all of her intelligence and common sense was deposited out through her vagina.
  • Uppity poor people.  Entitlement, entitlement, entitlement.  Free, free, free.  To them, the world is fucking free and WHY IN THE FUCK are you not giving them trade name medication!  Don’t get me wrong; 99% are awesome people who really do appreciate what is given to them by the state and just take their Rx’s without complaint nor bitch.  The 1% however are begging for a one-way ticket to reality-check land.  From wanting trade-name medications to complaining about their almost non-existent copays, these folk ham it up in the poor department for a slice of the pity-pie.  I’m sorry, but I have stopped feeling sorry for you after you dropped $20 in earrings instead of that $1.00 copay for your kids antibiotics.  I wish these people would die in an Escalade fire.
  • Snobby rich people. I want TRADE NAME HCTZ.  They want trade name shit that hasn’t been trade name in 30 years!  They want trade name hydrocortisone 1% and trade name prednisone!  I wish I could give them generic and charge them AWP +10%.  Paying more for something must make it work better.  At least someone should get something out of all of the bitching.
  • Phillipino Home Health Nurses.  Along with being pushy as hell, can’t speak English, and barely know a fork from a spoon; when they finally get done barking out orders to me (like I’m sort of employee subservant dog of theirs) I have to use every ounce of patience to not give them both barrels on the phone.  I mean really, do you have to ask me why their blood pressure is up after you told me 2 seconds ago they have a FULL bottle of Norvasc sitting on their dresser?  Medication is only useful if you actually take it, so their potassium is not going to magically come down while that unopened bottle of Kayexelate I dispensed 2 days ago sits there untouched.  Last one called in orders for Humulin when the doctor specifically told her to call in Humalog,  Whoops.
  • PBMs (MedImpact, Argus, Blue Shield, Wellpoint).  Why did I go into this profession when I’m getting reimbursed less than my pizza boy makes in tips for 1 delivery?
  • Addicts. Lie lie lie, lie lie lie, lie lie lie.  MY DOCTOR SAID I CAN HAVE IT EARLY.  Listen, I don’t have the word “stupid” tattoo’d across my forehead, so after the 4th or 5th time you pull this “doctor said” bullshit (and I call the doctor to find out you lied to me 4 or 5 times), I’m going to stop calling the doctor and just outright tell you no.  Yeah, you’re in chronic pain; yeah, your fatsomyalgia is acting up again; but honestly, I can’t prescribe or dispense your dope early!  Its not my fault you burned every bridge with every ER and doctor in town who pegged your pills with “MUST LAST 30 DAYS”.  Crying to me isn’t going to work either.  Sure, I’ll transfer it to another pharmacy, only if you don’t come back.  This class of people really drains you as they slowly chip away your sanity and patience.  I mean after the 5th phone call to see if their pain pills were approved early you sorta just want to fill them so the’ll leave you the fuck alone.  They are worse than nagging children solely because their vote in the presidential election counts as much as yours.

And last, but finally not least:

  • My uppity readers.  These people somehow think this site is all about happiness or pharmacy-life.  Its not.  Its about the shit that pisses ME and every god damn pill-pushing pharmacist/tech out there off.  If you get offended, here is a novel idea.  DONT READ IT.  I’m tired of working 8 hours a day in an environment that has deemed it deeply offensive to speak your mind in the name of “Political Correctness” retarded bullshit.  I use this site to rant and bitch so I don’t go suck on the shotgun barrel of sanity.  So if you feel it necessary to tell me your life story about how you have chronic pain, and post some 40 page comment about how you think i’m an asshole thats fine, however know that I don’t really give a shit about you nor what your biased feelings are about pain management.  You’re going to justify that pill-seeking behavior is right and just dispite pages upon pages of pharmacists bitching about it.  So next time you feel ranty about how I’m a big meany pharmacist remember that you don’t work in a pharmacy (hell, you probably don’t work period!), I realistically don’t act at work the way I act here (duh), and there isn’t a retail pharmacist out there who wouldn’t stand behind this site and tell you “you’re a dumbass, TAP is right”.