Category Archives: Pharmacies

Professional courtesy and shitting where you sleep

angryPharm.jpgAm I the only one who gets disgusted quite frequently at our own profession?  Take professional courtesy for example.

When a pharmacy calls me for a copy, even if its a chain whom I hate, I always make sure that copy goes into the fax machine as quickly as possible.  When a pharmacist is on the phone to ask a question or to request said copy, I treat that phone call as if its a doctor holding.  I drop everything and answer the phone. 

Why? Because its called professional courtesy and I strongly believe in not shitting in my own bed.  Eventually I will need a copy from that pharmacy, and I much rather would treat my colleagues how I would like to be treated. 

However, there are pharmacies in town who make me wait on hold for 20 min to request a copy, then take their own sweet fucking time faxing the information over (sometimes 2-3 hours).  After waiting by the fax machine (as the patient is pacing around the store), I call to get the “Oh, we’re really busy”/”I’ll get to it” excuse.  I’m fucking sorry, I’m /just/ as busy as you are however I tend to put people in my own profession (and doctors) a notch above the village idiot who is calling for his soma early.  Hi? Remember me? A pharmacist JUST LIKE YOU.

I’ve been tempted to drive down the road to the local chain(s) and go take a steaming dump on their counters for how some pharmacists they employ treat their own.  Sure, we might be competitors and by faxing copies you are in fact taking business away from your store, but take a step back on how this looks to the patient.  You make it seem like you really don’t give a flying fuck about the patient if he’s not getting Rx’s filled at your store (which if you work for a chain you very well could not).  Now, after 4 phone calls from me and wasting the patients (and my own) time, do you really think that patient will ever go your chain again? Of course not.  Do you think that I’ll go out of my way to help you out in the future? Of course not.

Time after time however I promptly answer copy requests from the chains in a prompt and courteous manner even though deep down I know that they really don’t give a rats ass about someone who they’ll see at the CE dinners, at the pharmacy association meetings, and the person who will advance them a box of Duragesic patches late Friday for a long-term patient of theirs.  Its really fucking disgusting at the lack of professional courtesy that some of the “pharmacists” show.  You put your own before anyone else, because by not doing so you are doing not only a disservice to your own, to your patients, but to someone who will cover for you in case you want some vacation time, insurance information/tricks, or someone who is going through the exact same shit you are going through.

So to the chains who take 4 hours to fax over one fucking piece of paper: Go fuck yourself, I filled that copy off of the bottle that your former patient brought in because you didn’t take care of business before sipping that coffee as you stare at your $100k script-pro that will soon replace you.

Oh, and see that awesome logo someone made for me up in the corner of this post? Yeah, those are pills he’s shooting out of that gun with the bandoleer of pill bottles.  Cool huh? Don’t steal it, its mine.  Coming to a coffee cup near you as soon as my fellow pharmacists stop pissing me off.

DEA is useful as tits on a boar

I hope the DEA is reading this, because they are not only a burden, but a tax drain on pharmacies and on the public in general.  Thats right DEA, I’m talking to you.  Lets show the whole world why you are as useful as tits on a boar.

In California, every pharmacy must transmit weekly a log of its controlled Rx’s that it has dispensed.  These are transmitted directly to the state as part of its CURES program.  Good idea right? Sorta.

Whats nice about this is that I can fill out some paperwork, fax it in, and in 1-2 weeks I get a nice printout via mail of all the narcs a certain patient is getting.  Of course this is after I can do absolutely nothing about it, but hey, its better than nothing.  To be honest these reports are downright useful. I would give lapdances if they would have an online system where I
could query in real-time my patients who might be narc-shopping.  It
wouldn’t even be hard, just limit it to patients that have gotten
something filled under the pharmacy’s DEA number in the past.  No HIPAA
problems there.

You should SEE the look on a patients face when you slide the report in front of them after they have given you both barrels about how you wont refill their vicodin early.  It makes it even sweeter when you say that you have faxed EVERY doctor on the list this report.  One woman even cried in front of me.  I almost felt sorry for her if she wasn’t a raging bossy commanding bitch who would go from calm to insane if you told her no.  See what happens when you lie to your pharmacist and doctors about pain pills?  Don’t give me this “She was in pain and it wasn’t controlled” sob-story bullshit.  If she took what the report said she received, her liver would of been blown out long by now.  Guess the Escalade is going to be repo’d now.  Pity.

Now, you may be asking why I think the DEA are useless with regards to the profession of pharmacy.  Well, they collect this information, but do absolutely nothing with it other than collect it.

In the past, when I was out of school and ‘Out to Change the World(tm)’, I would call the DEA when I saw doctors with “funny” prescribing habits.  Say like a month’s worth of vicodin written out every 10 days.  You know, stuff that your pharmacy will blacklist a doctor for (not piddly stuff like an oncologist giving an early fill once in a while).  I call the DEA and the Bureau of Narcotic Enforcement to get some ignorant dillhole who had no idea why I was calling.  5 transfers later, still nobody who had any CLUE as to why I was calling or who I should talk to.  Wonderful.  Fuck you DEA, I tried to help so now you can do your own fucking job.

To make matters worse, they are cracking down on the wholesalers.  Did you know that I can order 80 bottles of concentrated oxycodone solution with no problems, but the DEA is forcing my wholesaler to only allow me to buy 2 x 1000 count of soma and 2 x 500 count vicodin per working day?  They say its to prevent pharmacy diversion, but lets take a closer look at this.

1. The wholesaler knows how many I buy (obviously).
2. The DEA gets weekly reports as to how many I dispense.

so

Per month/year/whatever, they take the quantity from the stuff I transmit (#2) + whatever stock I have on hand (my vico-dans, let me sho u demz) and that SHOULD be ballpark to what my wholesaler sells me (#1).  Since we have to do stock-on-hand estimates every 2 years, that can be the ballpark starting inventory before the tally takes place.

However the DEA, in their infinite wisdom, is mandating my wholesaler take PICTURES of the pharmacies (to which my boss promptly flipped off, there were patients in the store so I couldn’t hang my bare ass at them) as well as sign a quadzilloin pieces of paper that say “I AM NOT AN INTERNET PHARMACY”.  They punish the wholesalers and the pharmacies because they are too stupid and/or lazy to use the information that THEY MANDATE WE GIVE THEM to determine who’s selling under the table and who’s not.  In a high volume pharmacy, 1000 vicodin is what, 10 rx’s?  Soma is 20 rx’s? Oh, did I mention that Soma isn’t a controlled drug? Tell me how that works and tell me why the DEA is sticking their noses into what I can and cannot stock and how much of it I want to stock.  What if there is a rumored price increase for soma and I want to buy a 6 month supply? Too bad.  Guilty until proven innocent.

So day in and day out we are the vicodin police living in fear of the dreaded DEA audit.  Those aren’t fun, when hell freezes over and the agents get off their asses and actually do one.  Do they care about phonies? Nope.  Does anyone care about phonies? Nope.  Even the doctors don’t care when the patient decided to give themselves 3 refills on their Vico-Dan ES prescription; “Oh, the’re in pain, fill it anyways – no refills”.  Yeah, write me out a check for $100 and after I add about 4 zero’s behind it you can tell the bank “Oh, he’s just poor, cash it.”

Don’t get me started at the whole logging Sudafed transactions.  What roomful of non-medical politicians decided to jerk each other off and pass such a shitty hole-ridden law such as this is beyond me.  Yay, I have a book that has every Claritin-D Rx in it.  So does every other pharmacy out there.  Doesn’t prevent the 18-wheeler full of sudafed thats being trucked in from MEXICO that the crank-cookers use.  Again, we can check our little books and realize that Juan Jose Carlos Maragariga VIII has been to every store in town to buy sudafed.  Will work really great after he’s arrested (or dead) after his lab blows up; BUT HEY WE HAVE THE LOGS TO SHOW HE BOUGHT SUDAFED (as if busted in a lab wasn’t enough).  The FDA shot themselves in the foot by pulling PPA off of the market because fatties were OD’ing on the stuff to lose weight – did they somehow not see this coming?

So DEA, after you are done subpoenaing me, auditing my store, ruining my life and wasting your time to find I’ve done NOTHING wrong, realize that pharmacists all over the country think that you pretty much suck and should stick your nose out of our business unless we call you.  We went to school to deal with this shit, you didn’t.  Oh, and give us a web-interface for all of the HIPAA violating data that you collect on a weekly basis. We can do *your* job a whole lot better if we can get the information NOW rather than after the patient has shopped every pharmacy in town (as if you will do anything about it anways).

ATAP: Medication changes and how I deal with them

I received this question from a doctor who frequents the site:

I have a question regarding changes in medication. I am a physician.
The way I usually handle it is that I tell the patient the new dose and
then write a prescription to reflect that dose. I then tell them that
they’ll have to go in earlier than usual to get a refill and to use the
new prescription to let the pharmacist know that the dose has been
changed. Is that the best way to handle it?

This is an excellent question. I far far too often have patients tell me (when they are out of medication) that doctor has changed the dose. Usually this is on a Friday night about 10 min before closing.
In the case above, you, Dr, are doing the correct thing. Seriously, I cannot express this enough that writing a new Rx for the patient to bring in (or fax over from your office) is the absolutely best thing to do. Telling the patient about the new dose is like talking to the sky (or filtering piss out of the ocean). I have seen more mistakes with patients getting their pills mixed up and taking double on something they shouldn’t have. Usually things turn alright, but when they get instructions to double up on their HCTZ and instead double up on warfarin, things turn sour really quick. If doctors always assume that their patients cannot wipe their own asses without written instructions, the world would be a better place.
This is what I do with a sig/dose change for which the MD has done “The right thing(tm)”:
When the patient comes in, I get the new Rx in hand, and right then I have verification that the dose has indeed been changed which I input into the computer and fill the Rx (if they are out). If the patient comes in and still has some medication at home I put the changed Rx on file, and if the drug & strength are the same I print out a new label and tell the patient to apply it to their old bottle (I write the Rx number down which to apply the label to). Usually the patient is smart enough to match 2 numbers together and apply a stupid sticker. However this is a huge judgment call, and on more than one occation I have told them to come back with all of their medications so I can do it myself. I instruct the patient to come in when they are out upon which I fill the Rx that was put on file and everything is happy in pharmacyland.
So if you are an MD/NP/PA/DO/CNM/Janitor who is reading this, here is a few tips on how to make your pharmacist love you.

  • Any changes in dosage or sig, write the patient a new Rx. Using a sharpie on my pharmacy label is just going to waste both of our times with a fax over confirming what you wrote.
  • If any medications are DC’d, let us know. Nothing annoys us more than to have to wait for a fax-back asking if the patients Lotensin needs to be DC’d because you wrote an Rx for Diovan. Its not that its a waste of our time, but the patient obviously has no clue what’s going on, and the terms “possible therapy duplication” is like speaking chinese to them. They have to come back to the pharmacy, or wait an unknown period of time until we get an answer.
  • Write down any and all information on the Rx that might save a phone call or fax when switching to formulary alternatives. Unless you really want Protonix for some god-forsaken reason (like the reps are giving you lapdances), writing “or equiv” will save us both a ton of time. A PPI is a PPI for gods sake.
  • If you have any questions about whats covered, a rule of thumb is that if its cheap and generic; its covered. Prilosec vs Aciphex, Lotensin vs Aceon, etc etc etc. Have you tried generic Mobic vs Celebrex? You should! If you don’t really care what NSAID the patient gets, then state “Feldene, but whatever is covered, therapeutic sig”. Any pharmacist worth his salt will take care of your patient and not bother you. We may fax you what we gave so you can keep your records updated, but we’re not going to ask you a bazillion questions if its okay. Remember, we went to school to learn about drugs; have a bit of trust in us.
  • Hate to tell you, but most NEW drugs now days are just knock-off me-too’s that are out because their replacement is going off of patent soon and will be dirt cheap. Look at Paxil CR, Coreg CR, Adderall XR, Lexapro. All came out shortly after Paxil/Coreg/Adderall/Celexa went off patent. You have been using these agents for 10-15 years, and all of a sudden they suck because something new came out? Think of it this way, if they were so “new” and “breakthrough” and “revolutionary”, then why weren’t they out when there was 5 years left on the patent on the drug they are meant to replace?
  • If you have any questions about pricing, call us. Seriously. Nothing makes me happier than churning my workflow to a grinding halt to answer a phone call from a local doctor wanting information vs some crackhead asking for their vicodin a week early. Believe it or not, we’re in the same boat, and we cant exist without each other, so lets actually talk once in a while.

Doing other people’s jobs

Now I don’t mind explaining to people how their medication works, how to take it, and what it does.  Its part of the job, and to be honest /most/ pharmacists really enjoy doing things like that (if they arent swamped to all hell).  We go to school to learn stuff to share with the general population and a more educated patient is a happier (and more dangerous) patient to both themselves, the doctor, and us.

However when you bring fucking filled Rx’s in from ANOTHER pharmacy or mail order place (fuck you Liberty Medical) and expect me to take time out of MY day to explain Rx’s that someone else made some cash off of, I start to get upset.

Mail order joints (fuck you Liberty Medical) are the absolute worst of them all.  I don’t get paid by Liberty Medical (fuck you)  to sit there and explain to you how to work your nebulizer or some proprietary piece of shit blood glucose monitor that only YOU can get the strips for.  You got it from Liberty Medical (die) so YOU can call them up and have them explain to you over the phone how to use this piece of shit.  I don’t care if you saw a TV commercial and called the fucking number, YOU deal with it, not ME.

Where in the fuck do mail order places get off thinking that I’m their bitch.  What pisses me off absolutely the most is when they TELL the patient to bring their drugs/devices/etc into their local pharmacy and receive instruction on how to use it.  You know what, FUCK YOU AND DIE.  You dispensed it, so YOU TELL THEM HOW TO FUCKING USE IT.  Oh? You’re in another state? Wait, let me bring a fucking 2L of ‘I dont give a fuck’ to your pity party.

The best is when the patient comes in with a blood glucose monitor and has no idea how to use it.  The patient gets maybe 1 Rx, 2 at the very most from you (and even then it was filled 3 months ago).  They come up with a Nation-Wide-Chain Rx label on the box the monitor came in and tell you “the pharmacist was too busy at Nation-Wide-Chain to explain to me how to use it, can you show me?”

At first glance I want to say “No, go back there and MAKE the son of a bitch cock-sucker show you how to use it.  What do I look like? His fucking lackey bitch who does the grunt work while he makes the money?”  Alas common sense and ethics kick in and I end up being a big pussy and showing him/her how to use the machine.  ALTHOUGH I do stick in the rib-jab of “You know, if you get your stuff filled here you won’t have to deal with someone who obviously doesn’t care about your well being to show you how to use it.”  TAP – 1 / Dildo Chain – 0

Really, this post makes me sound like a grade-A asshole that shouldn’t of gone into pharmacy.  However take a second and think of all the time we spend on the phone answering questions FOR FREE, how must OTC advice we give out FOR FREE, and the only concrete way to earn money that will pay for food on our table is by filling Rx’s.  Its bad enough that we’re one of the only professions that gives out tons of information FOR FREE that we went to college to exclusively learn (why cant Lawyers or Doctors be the same way?), but do we also have to deal with the lazyness factor of our own profession?  Do I have to take up the slack because someone ‘didn’t have enough time’ to explain something (and made the dispensing fee off of it) or is in some warehouse in another state?  Its not that I nor the people who agree with me don’t wish to help people, but we have our hands full with OUR patients who come to US and ONLY US  without having to deal with the overflow of shit from mail order places that dont give 2 flying fucks to Sunday about patient care.  Patients are just an ID and an Rx number to these mail order places.  There is no patient contact, no patient care.  They make pharmacy look like a fucking industry rather than a profession.  Fuck mail order joints, and fuck Liberty Medical with their fancy commercials that trick old retarded folk into getting their shit from them.

PS: Fuck Liberty Medical, the horse they rode in on, and their fucking commercials.  I’m tired of cleaning up their shit and doing their job.

Cherrypicking

I hate cherry-picking pharmacies.  If you are new to this term, this is what it means.

Cherry-picking is the act of filling a bunch of easy Rx’s for a patient, then giving the Rx back (with the filled Rx’s crossed out) to the patient telling him/her to go to another pharmacies to get the other (harder) Rx’s filled.  99% of the time the unfilled Rx’s require a prior-auth or paperwork to be filed for payment.

This pisses me off to no end.  Give me the shit-work while you get money for the easy ones.  I hate pharmacies who do this.  If you are going to make me fill the hard ones, then give me the easy ones as well.

So say a patient hands you an Rx which another pharmacy has pulled this shit on you.  What do you do?

  • Do the paperwork to get the hard Rx covered?
  • Call the other pharmacy and bitch at them as to why they got the easy ones while you are stuck with the hard ones?
  • Give the Rx back to the patient and tell him/her to go back to the other pharmacy and make them do the shit-work?

There’s no real right answer here.  Pharmacies who preform this bullshit backstabbing should be fucking firebombed and their pharmacist strung up by his testicles/labia.  If you are going to fill an Rx for the patient, then do all of them, not just ones that are the easiest for you.  Not only is this bullshit for the patient, but bullshit for the pharmacy that has to face the patient and tell them that their Rx is going to need a prior auth.  Just because I do prior auths does not mean that I’m your bitch for you to walk all over me.

Typical how chains are notorious for doing this.  Fuck your company policy about not doing PA’s.  If thats the case then just send them to me with ALL of their Rx’s and I’ll do what your lazy ass wont.

Chain Pharmacists have it SO HARD

Theres some talk about how bad pharmacists that work for chains have it.  Be it under staffing to bad working conditions to a store manager that only dealings with a pharmacy is buying extra small condoms.

There is one aspect and benefit that Chain Pukes have that us Independents don’t, and I think that its something huge that they take for granted and really shut their mouths when its brought up.

Job Security

Thats right, Job Security.  You see, with an independent, we don’t have a multi-billion dollar company backing us up.  We don’t have a corporate office that we can just defer shit to.  We don’t have a guarantee that our paychecks will cash every two weeks.  When huge Medicare/Medicaid cuts happen and the reimbursement goes down to shit, we don’t have the luxury of over productive stores to help float us during the bad times.  Our bank accounts are not tied to a place where people in suits crunch numbers and fancy lawyers give us advice.  We’re out there on our fucking own doing it the old fashioned way, the “old school” way.  The way our grandfathers did it.  Our “corporate office” is the owner of the store trying to get the fucking payroll done in the back room while handling calls from doctors office so we don’t die up there in front.

You know what we get when the shit turns sour? Walking papers and a chance to search for a new job.  Thanks for fucking playing.

Furthermore (to make you all look like a larger big whiny sandy vagina), we are just as overworked as you, and we still have to deal with the same shit that you do.  Same patients who want and demand everything, same insurance companies that fuck us over (only WE have to do our OWN recon sheets and we don’t have the “power” to negotiate), and we shafted by the same expensive drugs (which is coming out of the OWNERS pocket, not a corporation pocket).  We watch reimbursements and what we order so we don’t put the business under.  We can’t hire more help not because “corporate office says that we need to hit x/day” but because we cant fucking afford another pharmacist.  Do we get to hide behind “corporate policy” or “well the corporate office says we HAVE to do this”? No.  Our “corporate office ” is usually the guy working next to you who has owned the store for 30 years and has his whole livelihood invested in not only his staff and store, but in his patients as well.

However you go to bed every night after bitching to everyone about how overworked you are knowing that your store is going to be open in the morning, while we sometimes have to wonder if our wholesaler bills will get paid, payroll will be made, and if Humana/WHP/Argus/etc will be on time with their payments.  We have to deal with the stress of not only running the pharmacy, but running a business as well; down to payroll, taxes, workman’s comp, everything.  Even buying the fucking bags that we put the drugs in with our names on them.

New graduates don’t want to deal with the shit of running a business.  They want to work in their nice chain store jobs with their stock options, vacation times, sign-on bonuses and the satisfaction of knowing that the business aspect will be taken care of someone whom they will never meet, and their paycheck will magically get direct deposited on the 1st and 15th.  On top of that they have the balls to sit there and bitch about how working for the chains is so fucking hard.  Hear that? Thats me playing the smallest violin for you.

So quit bitching.  I’m tired of it.

Black Monday after Thanksgiving

For as long as Pharmacy has been in existance, there has always been the Black Monday after Thanksgiving. For those not in the profession, since Thanksgiving is always on a Thursday, that weekend (for the doctors and some smaller pharmacies) is always a 4 day weekend that always ends on a Monday.
This means that you have about 3 days of Rx’s that have been stacking up while the doctor has been away (or the pharmacy has been closed) that are just waiting to explode all over your face the following Monday.
As I write this, black monday is over (at least for me). I hope you all have a vice filled night.
Just for shits and giggles, post your average and how many you did today in the comment. Our average is about 375 and we did over 500 today.

Shooting ourselves in the foot, $4 at a time

Say you are an insurance company, and you are looking at reimbursement rates to give to your participating pharmacies. You settle on something thats totally short-cutting the pharmacy (like cost + $2.50). All is well because the pharmacies don’t really have much of a choice.
Then lo and behold some fuckers at Publix are giving away antibiotics for free. Then you see Walmart and other douchebag chains giving away Rx’s for $4/month. Obviously they are sending the message that we can afford to give shit away for free/below cost because we obviously are making too much money filling other things.
To Publix and the $4/month chains: Thanks for shitting in our beds. In an attempt to drum up business under the false pretense of “helping people” you have shit on the rest of us who don’t have multi-million dollar corporate offices to float bouncing paychecks. You are fucking up the profession of pharmacy far more than you will ever gain. Don’t you see that the insurance companies see this shit? Don’t you think that you are publically lighting your cuban cigars with fresh $100’s and blowing the smoke in the faces of those who hold our business (reimbursement) in their hands? You are ruining it for the rest of us. You are giving those rat fucker insurance companies enough ammo to cut their reimbursements even more to us. You are shitting on the little guys and turning our own profession against itself for your own selfish corporate greed.
So yeah, if you are so gung-ho to give away shit for free or below cost, then why dont you pharmacists there work for free or below cost. I’m tired of having to hear people bitch about $4/month drugs and free antibiotics due to fuckers in our own profession. Way to go guys, way to go, you’ll need those free antibiotics when the insurance companies get their heads out of their asses and bend us over.

How do you price your drugs?

I have a legit question. You may comment anonymously, use a fake email and name, however you wish. I’m not going to go running off taddling on you all for answering this question, I am legitly curious.
How do you price your medication? I’m just curious how the chains do it vs the independents. Do you take like “AWP + Dispensing Fee + %age?” Or “Direct Cost + Disp Fee + %age?”
It seems like the price of generics fluxuate between pharmacies to bargan basement (independants) and ass-rapeage (Walgreens/Rite-Aid). Do the chains just accept pricing from the corp office or do they have some say (such if a patient has like $10 for atenolol, and the price is like $11.50, can you lower the price?)

Mail Order Scum

Now everyone knows that nobody is safe from The Angry Pharmacist(tm). I always wonder why I never get featured in Drug Topics or any other pharmacy magazine that pharmacists read while taking a dump. I guess I’m too hard core (or use bad words way too often) to be in any cool magazines. 🙁
Oh, yeah, mail order pharmacies.
Lets just say that I hate Mail Order Pharmacies. Plain and simple. If you work for a Mail Order pharmacy, seek a career as a prostitute or maybe a Drug Rep or something. My hatred is from a multitude of colorful points that every retail grunt knows:

  • Mail order places get kickbacks from the insurance companies. Yes, I said kickbacks (not rebates, but fucking bribes/kickbacks). Why cant retail pharmacies dispense a 3 month supply for 1 copay (without losing money, a la Walgreens Medicare part D). Why do mail order joints get special deals on “Mail Order Only” test strips and supplies? Why do mail order (and hospital) pharmacies get special price breaks on generics? Oh, kickbacks. Did I mention that some insurance companies will only allow 3 fills at a retail pharmacy before mandating the patient use their mail order pharmacy? How can you say thats not kickbacks. Seriously, get your head out of your ass and wake up and realize that Mail Order pharmacies and the insurance company’s asshole they screw every night are making not only us retail folk look like money-grabbing bastards (“how dare you charge me $5.00 copay/drug a month! I get $5 for 3 months from my local mail order pharmacy!”) but………….
  • They waste our time! How many of you retail folks have had a Mail Order patient come in with a sad-panda face and an empty mail order bottle saying “Uh, my mail order medication got ‘lost in the mail(tm)’. Can I have a few atenolol so I dont die?” The Angry Pharmacist(tm) in me wants to say “Fuck you! You said that I was ripping you off for charging you a copay every month (because their insurance company wont let us fill a 90d supply, only their mail orders get to do that) and now you come begging and groveling to me for medication because it got lost in the mail? HAHAHAHA DIE!” but the actual pharmacist in me doesn’t want to see more of the MediCare money (that i’ll never see) wasted on a pointless ER visit (see DrugNazi, I care). So I charge him a whopping dollar for like a week of atenolol and send him on his merry way to go fuck me behind my back with his Mail Order Pharmacy mistress.
  • Patient comes in (who you know goes mail order) with a brand new testing machine. They plop it on the counter and wish to know how to use it. They said “The mail order pharmacy said to just take it in to any retail pharmacy and they’ll show me how to use it”. Uh, go fuck yourself? Do I work for the mail order pharmacy? Is my employer going to be happy that his over $1/min pharmacist is out helping a patient (who will never trade with us) with his machine that another pharmacy made a fat profit on? Let me consult you on the medications that Walgreens filled for you while I’m at it. We all know those chain pukes are too busy to actually do anything than shovel Rx’s out the door and drink coffee, so let me do their jobs for them (for free!).
    While I’m ragging on “The Pharmacy America Trusts(tm)(r)(blah)”, did anyone read the article on how a Walgreens DC has over 40% of its employees have a “physical or cognitive disability”? Now I realize this is a distribution center and not an actual store, but have you ever tried to get a copy from a Walgreens? Have you ever tried to speak with one of their clerks? Yeah, I’ll just stop right there. As a sidenote guess how many of my Walgreen buddies got a fax when that article came out. 🙂 I’m so loved. Back to hating on Mail Order.

  • Doctors offices are even getting bribes from Mail Order joints. We have had more than one patient suddenly (and unknown to him/her) that all of his Rx’s were mysterously filled by a mail order pharmacy (we tried to fill them, and the insurance company gave the reject). A few phone calls later we found out that this Mail Order pharmacy that “partners with the doctor” magically got a full copy of all the meds this patient was on, and filled them without the patient even knowing what was going on. The pretense was that the medication was going to be “Waiting for the patient in the doctors office” so they “Didnt need a trip to the pharmacy”. Did I mention that said mail-order joint filled a 3 month supply when the insurance company put a 30 day restriction on retail? Amazing how fast the claims got reversed when the word “kickback” and “bribe” got thrown around between us and said Doctor/Mail Order Pharmacy.
    So what can us retail folk do about this? Complain to the insurance companies? No, they are in on it. Complain to the Doctor? They don’t care, not their problem. Complain to the State Board of Pharmacy? HA! The Mail Order place is in another state, good luck!
    Guess we bend over and take it. The problem is that unless we are total incompassionate dicks (not only a failure to our profession) and make folks go to the ER when their mail order shipment gets “lost”, they will never learn. Unfortunately I’ll be the first to admit that even I am not that much of an asshole. I have to ™ my shit or else the angriest pharmacist will steal it(tm). Heh.