Category Archives: Hate Mail

Oh jeezus, I pissed off the diabetics now.

Ah look, the diabetics come out of the woodwork. WATCH OUT, I HAVE CANDY AND I’M NOT AFRAID TO USE IT! I would like to point out that below I refer to diabetes as a ‘condition’ and not a ‘disease’. See, those PC/sensitivity classes are paying off. πŸ™‚
On the other hand, when I piss people off they come to the site to whine, read past entries which makes them laugh, then they keep on coming back. Just ask The *Angriest* Pharmacist (or is his case, copy me) :).

As a pharmacist it is none of your business haw many strips a patient
uses. Strips in no way can hurt a patient and one can not overdose by
using too many. If a doctor writes a prescription for an unsafe dosage
of a medication then the pharmacist is correct in questioning the
order, however this is not the case. As far the insurance company, one
should ask, are working for the insurance? are you the insurance
police? who made you in charge of determining how many times a diabetic
can test? I think you should go about your business of filling
prescriptions and leave the ordering to the doctor, and not worry about
how many strips the insurance company should allow.
Interestingly, if a person goes into a drug store and purchases 100
bottles of strips each month and pays cash for them you wouldn’t ask
those questions. You would be thankful for the business, but because
insurance is involved you feel you have a duty to limit the amount of
strips uses.

Woah, wait a second. You’re telling me that its not my business to deal with how many strips a patient uses for a condition that I fill Rx’s for? Since you obviously have no idea what goes on in a pharmacy, let me enlighten you. Every Rx you fill has a day-supply associated with it. If 50 test strips lasts you 10 days (and you aren’t on insulin), the insurance company is going to come to ME and want ME to submit documentation to justify a type-2 diabetic (who cannot control the dosage of his medication) testing 5 times a day. Do I have any? No. There goes 50 bucks from my next reimbursement check. Simple as that. If you want to pay cash for your strips thats fine, but if you want the insurance to pay for your strips then we all have to play by their rules, you dont like it then pay out of pocket for your strips. You want someone to pay for your life then deal with it.

Where in heaven’s name did you go to Pharmacy School? Didn’t they
teach you that a non insulin-dependent diabetic also needs to know how
their diet and stress are affecting them?
Every bite they put in their mouth will raise the blood sugar. To
avoid the complications of diabetes (yes, all diabetics are susceptible
to them, insulin-dependent or not) these people must know exactly where
their blood sugar level is at all times.
Another factor that can cause the blood sugar to rise is stress. When
the liver senses release of stress hormones, it releases sugar into the
bloodstream to fuel energy for the “fight or flight” response.
All of these things must be learned and then checked and rechecked.
Can you imagine someone wanting to make themselves bleed for the fun of
it? Being a diabetic is no fun, especially with people like yourselves
imagining how simple it all is.
Shame on you.

Yeah, thats great, the patient knows that eating a ton of candy raises their sugar into the 400’s. Thats maybe 2 or 3 tests at the absolute most to confirm that. What can they do about it? They can’t adjust their medications to compensate for this so why bother testing. If you eat something and it boosts your sugar sky-high twice, then obviously you know what NOT to eat. Is there justification for testing 5 or 6 times a day everyday for months upon months for something that you have NO control over? I mean how many months does it take for someone to learn what they CAN and CANNOT eat. After 6 months of trial and error of what works and does not work what excuse do you really have to test that often?
You say that they must know exactly where their blood sugar is at all times. Yeah, thats great, if they are insulin and can do something about it. What are you saying? That they should skip meals if their blood sugar is through the roof? Thats not healthy either. “Oh look, I ate birthday cake and my sugar is up to 400, guess I can do nothing about it since I already took my 2 glyburide bid and 1 metformin bid today.” At least the folks on insulin can compensate, oral meds not so much. Lets look at the gas gauge every 3 miles but not stop for gas when we’re at empty. Oh, and lets throw away $1 every time we look.
Oh, and guess who gets to suffer if the payer of your test-strips doesn’t like how much you are testing. Its me. Not you, but me. If you want to test 100 times a day and pay cash for your test strips, thats fine, more power to you. However when insurance companies are paying the bill then YOU need to abide by what rules they set up, and trying to get doctors to provide justification for a type-2 diabetic who burns through 5 strips a day for 9 months and is noncompliant as fuck on their medication isn’t my idea of a good time. In fact, it has cost me on more than one occation a filling or 20. Do the math at a little over $1 a test and tell me why i’m a bit pissed. Plus this puts me into a bind. The “diabetic” (I use that term loosely since they obviously don’t take any initiative in their care) needs their strips, but there is a good chance that the insurance company wont cover it. The patient can’t afford $100/month in test strips. Do I chance it and cost the store money or do I do what you all think is “right” and possibly eat $100/month x 20 patients/month.
My argument was that testing 5 times a day is an absolute waste if you can do absolutely nothing about it like most uncompliant type-2 diabetics. I know plenty of very compliant type-1 diabetics on insulin pumps or rock-solid awesome Lantus/Humalog setups and some very compliant type-2 diabetics who test once or twice a day and have A1c’s in the 5 range. I have patients who come to me (rather than their doctor) and say “Listen, I’ve been running in the 140’s every morning for the past week, nothing has change, can you talk with my Dr about increasing my medication?” As you all know, diabetes is one of those conditions that requires the patient to be an active part of their care and management, and I’d rather see the funds be used to paying for test strips for the complaint patients who actually /care/ about their sugar and test smartly than the non-compliant patient who throws tests away just so they wont get yelled at by the doctor during their next visit. Pissing away 5 tests a day does nothing unless you are doing something about it (and after 6 months when the insurance companies catch on, you should of done something about it).
Let me tell you a little secret. The reason why diabetes kills a ton of people is because the people who have it really don’t give a shit what happens to them and really want someone else to deal with their condition. Obviously there are people out there (ie: you) who *gasp* take an active part in their condition. If the insurance company audits me for test-strip usage and you get your meds filled every month as well as a blood sugar log printed out thats 20 pages I will gladly throw that back into the insurance companies face with a hard-on the size of the empire state building. However patients who actively manage their disease are few and far between. Most of my patients just take the pills, eat whatever the hell they want to eat, and just pretend that everything is okay no matter how many times I scream at them for having a 300 reading first thing in the morning. They dont feel pain, they dont really feel much of anything (other than peeing a lot) and life goes on. I can consult them until I am blue in the face, but until something BAD happens to them they will just pull the smile-and-nod game. Thats okay if they are paying for their stupidity, unfortunately they are on the system, so I tend to get a bit pissed since the taxpayers are footing the bill.
I know this sounds crass and crude, but I’m really surprised diabetes doesn’t kill more people than it does for the sheer lack of common sense and responsibility that I see on a daily basis, especially from “diabetics”.
Its sad really, but no matter how much you say they are going to die/go blind/renal failure/amputation most diabetics really dont give a rats ass about their condition.
Plus we need a token comment from someone who obviously arrived to the game LATE and with their shirt on inside-out:

You need to find a new occupation. This obviously is not your expertise or passion. While you are at it, go to school and learn how to use the English language to express yourself. If you can only use foul language, obviously you need some serious help in learning to express yourself intelligently.
oh….. have a nice day! πŸ˜›

Uh, what site is this again? I’m sorry, last I checked I was the ANGRY pharmacist. Obviously you need to go to school and learn to realize the obvious: that a site that has the word ANGRY in it is going to have some swearing and other ANGRY things in it.

14 and Pregnant – The Saga Continues

Amazing that I still get comments to my rant about the 14 year old pregnant girl. Before all of your pregnant teens jump down my throat screaming “RAPE” (since you all obviously think that EVERY pregnant 14 year olds was raped); Keep in mind that the original post did say that the father of said pregnant girl came into the store with her. I doubt if she was raped the father would be there.

this 14 yr. old WOMAN is not stupid or anything.

Uh, justify that please. How does having a kid when you are not even out of high school considering even remotely a smart idea? Unlike yourself, I would prefer to get an education and get a JOB so I can be financially stable enough to give that kid the best life I could. Somehow I don’t see this person accomplishing that.

14 yr old girls have desires and wants too.

Thats fine, I also have a desire and a want to not PAY for this child because the mother is an idiot. She should DESIRE to use a condom or some of the 100 billion forms of birth control. She should DESIRE to not cave into peer pressure and let some douchy fag tell her he’ll pull out in time. Plus you call her a WOMAN in your previous sentence, and a GIRL in this one. Stay consistent with your terminology please, you are just making yourself look like a bigger idiot than you already do. Choose one, GIRL or WOMAN. I am using GIRL because she is in fact that.

and her parents.. what are they supossed to do be
mad at her the rest of her god willing life??
huh? well if i had a daughter and she got pregnant at 14, i apsolutley know
i would be very upset and disapointed but i wouldn’t show it around other
people. and you would forgive ur daughter if that happened and you know it!

Being tolerant and forgiving is not expressing delight in front of other people. If I had a 14 year old daughter and she got knocked up, I would feel shame every time I went into public with her. Yeah, call me a hard ass but I would raise my child to be smarter than that. The chances of a 14 year old actually being successful in this day and age is close to nil. Not saying that it can’t be done, but most 14 year olds do not have the mental strength and determination to make it. Sorry if you don’t agree, but I’ll give you 100 examples of pregnant teens on the system for your 1 that actually makes it.

people make mistakes wheather they mean to or not they are just PEOPLE not
PROPERTY. and you have prob made a mistake too.

I dont make mistakes that last 18 years and become a financial burden. We aren’t talking about something that is unpreventable either. This is a completely preventable problem that takes a bit of common sense, 2 seconds of prep time, and a basic knowledge. Oh, and once you are on the state program I do consider you to be property. The state pays for you, the state owns you. If the state wants you to go pick up garbage and plant trees for 8 hours a day then you should have to. If you don’t like it, get off of welfare.

plus why is it any of ur
business if she wants to have sex and gets pregnant. its not ur life so why
don’t you just but the fuck out of her business and worry about yourself.
F.Y.I – when a girl first gets a period they turn into a woman. smarty.

Uh, I have to pay for said female and her crotchfruit now for the rest of their lives. All because the mother could not use preventable measures. So yeah, it does effect me, it effects all of us. Obviously from your horrible spelling you are either a teenager or someone who obviously did not finish school because you had a child at an early age. I wont hold this against you however, you just hammered my point home far greater than you could ever imagine.
Thank you for letting me know that when a girl gets a period she becomes a woman. I had no idea. All this time I thought that girls were in fact girls until they GREW UP enough to make smart decisions and support themselves. Getting knocked up at 14 not grown up, and not making a smart decision. This isn’t the 1920’s where you had children (and got married at 14) so you could have WORKERS for your farm. If you had two braincells in that empty noggin of yours you wouldn’t be defending this girl fully knowing that in this day an age an education is everything. If you want to throw your future away over an orgasm thats fine, just don’t do it on the dime of all of us who had a bit more common sense and foresight.

What? Medwatch? I’m confused

You state: Now I went to college for 7 years, got my PharmD, yadda yadda
yadda. I know about drugs. I am trained in drugs. Ask me about a drug
and I will tell you everything you need to know about it.
Okay–I’m asking about a drug: INSULIN. Tell me everything I need to know
about insulin . . . about older OTC natural animal insulins versus the rDNA
synthetic human insulin that is “just like the human body makes.”

What do you want to know about it? How its more consistent than animal derived Insulin? Less prone to allergic reactions? Longer shelf life (if kept in fridge)? Less shit from animal-rights groups (god save the pork?). Or should I go into the long tyrade about how EVERYONE can use this product without being forced not to get treatment due to religious beliefs of not using pork products? When I said “I will tell you everything you need to know about it” with Insulin its going to be how to store it, proper aseptic technique to inject it, when to notify your doctor, confusion about sliding scales, mixing, etc etc etc. Basic stuff they tell you in school. However you are a “50+-year insulin user” (See lilly rant) so I think you’re going to tell me that my 7 years of school + millions of bottles of insulin dispensed is completely wrong and I’m an idiot.

And while you are at it, I would like to know why pharmacists–whose years
of education supremely qualify them to serve as an intermediary between
patients and the FDA–have NOT stepped up to amerliorate the dysfunctional
adverse events reporting. It has been shown that patients talk to their
pharmacists 7 times more frequently than to their doctors. Ergo, you hear
more tales, more quickly, about adverse events; and yet you obviously have
opted to stay out of the mix, count your little pills, place them in
bottles, and ask patients, “Do you have any questions?” Your education and
position qualify you to do much more. Why don’t you?

If I reported every damn ‘side effect’ and ‘allergic reaction’ that I get on a daily basis, I would fill up medwatch’s books on “headache”, “upset stomach”, “dizziness”, “gives me gas”, etc etc etc. We filter out a /ton/ of bogus already-reported side effects from Medwatch. Now have I ever reported something to Medwatch? Yes. Woman had such a bad allergic reaction to the adhesive to Vivelle dots that it made a bleeding rash that spread. We arent “staying out the mix”, we are just nodding our heads and telling Mrs. Jones who calls you 100 times a day that YES, it is common to get lightheadedness when changing blood pressure medications, and if she wasn’t being such an uppity bitch about her copays she might of heard me warn her of that during the consultation. People hear what they want to hear, and the moment their copays change by anything more than $0.05 anything of value I tell them goes right out the window as they scream at me about their fucking copay.
I dont see where you are getting with this whole bitch to be honest. We ask the patient if they have any questions, yet don’t submit every side effect to Medwatch? Do you call the police about a missing person when your child cannot be found for 10 seconds because they are in the restroom? You’re probably one of those patients who has an “allergy” to codeine and tells us to record it as “upset stomach”, then argues with us when we say that its a common side effect.

In other words, what YOU perceive as your STELLAR qualifications could–and
perhaps will–be supplanted by a comprehensive PDR software program,
automatic pill-counter/dispenser, and voice-activated computer that can
spit out prescription inserts “on demand.”

Yeah, and who’s going to program said PDR software program that can turn medical speak into plain-person speak? How are you going to get around the Drug-Drug-Interactions/Dosing Mixups that aren’t picked up in the software but are picked up via experience (Morphine ER/IR mixups or a good starting dose for the elderly). We aren’t going to be replaced by machines because people like us, we talk to them.
Doctors have more of a chance of being replaced. They see patients for 10 seconds, take a quick look at them, and just leave giving them an Rx on the front counter. They could be replaced by an automated blood-pressure/DM/etc diagnostic machine, then patients can use a touch screen for their symptoms which spits out a diagnosis that then gets sent to the pharmacy where we pick out the proper drug and dose.

It sounds to me like you should be working at a mail-order pharmacy where
patient contact is minimum. That should take care of your ‘anger’ issues.
Then, of course, without those stupid, sick, suffering patients–and yes,
sometimes thoughtless or clueless patients–you wouldn’t have a job.

Do you realize that you are on the website “THE ANGRY PHARMACIST”? What part of “Angry” do you not understand? Have you ever read this site before? Do you realize that the whole reason /WHY/ I get angry is because I’m out there associating with everyone who walks into my store? This includes the village idiot, the whiny uppity rich bitch, and the 99.9% of the /normal/ people whom I don’t get angry with (hence not bitch about here). Did you read how I /hate/ mail-order pharmacies because they give substandard patient care and make /me/ do all of their shit work (when I dont get paid for it)?

Dr “4 Degrees” and the Caps-Lock key eludes him

Sometimes all I need to do is to just check my email for a laugh:

for the pill counting pharmisist why is he playing drr?HE ISNT THE ONE WITH
A MEDICAL DEGREE AND ITS NOT HIS DEA NUMBER AT STAKE AND THERE IS NO LEGAL
WAY HE KNOWS THE PATIENT HISTORY.TOO MANY PHARMASCIST WANT TO PLAY POLICE
AND DR, FOR THE 1 PERCENT WHO ABUSE AND THEY WONDER WHY MOST ARE GOING MAIL
ORDER TO HAVE FILLED.MOST RX PEOPLE TAKE FOR A PERIOD OF TIME ALL THEY NEED
IS PILLS COUNTED AMD REFILLED. PHARMACISTS WHO CALL DRS. MULTIPLE TIME HAVE
NOTHING TO DO AND MDS DONT HAVE THE TIME,TODAY YOU HAVE TO SEE 5 PATIENTS
VERSUS ONE TO MAKE WHAT WAS MADE IN 1995 AND DONT HAVE THE LUXURY OF 8 HR.
DAYS COUNTING DOR 100K A YEAR.THIS COMES FROM A DR, WHO HAS 15 YEARS OF
SCHOOL AND 4 DEGREES

Right, this comes from a doctor who has 15 years of school and 4 degrees. You would think a “doctor” of this caliber would know how to write in proper English or at the very least knows how to use the Caps-Lock key.
I’m not playing “dr”. I’m doing my fucking job. Obviously if you write a sig on an Rx, and that patient chooses not to follow that sig, then I can choose not to fill the Rx, plain and simple. Plus, when I’m bored with all that LOADS of free time that I have, I decide to call MD’s just to chat. Us pharmacists have a secret game that we play called “piss off the MD” where we call up a bunch of MD’s and time how long we can tie them up on the phones! Its fun! You should play! Then, after you play, you can yank your head out of your ass and realize that what you wrote above makes no sense.

WHO IS THIS ANGRY PHARMACIST WHO WONT FILL VICODEN WITH OUT BUGGING THE DR.
AND WONT FILL RITALIN OR OTHER DRUGS THAT THE DR. ORDERS IN WHICH HE CANT
KNOW IF ITS APPROPRIATE OR NOT FOR ONE THING HE HAS NO DR. DEGREE LET ALONE
MD.HE NEEDS TO FIND ANOTHER PROFESSION BECAUSE SOON THE 100K HE MAKES AND
HIS NICE CAR AND HOUSE HE OWNS IS GOING TO BE ONE OF THE PATIENTS AND HE
WONT HAVE HIS PILL COUNTING LICENCE ANYMORE. FROM THE DISGRUNTLED PHYSICIAN

I dont know if its appropriate or not because I have no doctor degree? Wait, actually I do have a doctorate, however I do not have an MD, so you’re only half wrong there buddy. It doesn’t take a degree in pharmacology to realize that if your patient is blasting through 120 vicodin in 1 week, obviously you are missing the boat entirely. How is my patient going to own my house/car/etc? Is he going to sue me for not dispensing his vicodin 3 weeks early even if the MD gives the ok for the 20th early fill in a row? Hate to tell you, but the DEA will side with me until the cows come home and will gladly plant that shiny DEA number that you covet so much right up your ass. You figure out why, you’re smart with your 4 degrees and 15 years of school.
Plus where does it even say on here that I wont fill a Ritalin Rx? Where does it say that I wont fill anything but the crackhead’s Soma thats 3 weeks early? You need to start reading the site before you fly off the handle. OH WAIT, YOU HAVE 4 DEGREES, IM SORRY.

WHEN DO THESE GET POSTED AND WHERE? IT APPEARS IT IS A PHARMACIST NETWORK AND IF IT IS CONSTRUCTIVE CRITISIM THEY DONT WANT TO HEAR IT,FROM THE MD

Ha! An MD who does not want to hear constructive ‘critisim’? Go figure! Thanks for re-enforcing every stereotype of the “I am god do what I say” MD that pharmacy students dread.
A pharmacist network? Thats right! You have stumbled upon a secret underground network of disgruntled pharmacists who’s sole purpose is to take over the medical world and make that plain-ole-stupid MD just obsolete.
Let me put it to you in a way that you will understand.
READ THE ACTUAL SITE BEFORE YOU GO OFF ON THESE TIRADES MAKING YOURSELF LOOK LIKE AN IDIOT. FURTHERMORE LEARN HOW TO USE THE GOD DAMN CAPS LOCK KEY.
Seriously, If I were an MD I’d be pretty embarrassed to have this guy in my ranks (but Im sure people say that about me. Eh, oh well).

Whats with the retail hateage?

Original is here
Before I tear this poster a new one, in his defense the last paragraph:

I know I’ll get flamed for all of this by the retail pharmacists who read this for being too idealistic and for not even being out of pharm school yet, but I’ve seen what pharmacy can be.

Ah, to be young and in school again. Anyway, on with the show.

I agree with your whole post except the one part. Your comment that profs couldn’t cut it in retail bugs me. In my opinion the profs that did the residencies and are making real clinical decisions worked a hell of a lot harder than those who got through pharmacy school and accepted the sign-on bonus from X pharmacy chain.

Because being someone bitch working for minimum wage in some hospital for a year makes you better than the retail folk? Makes you ‘harder working’? Tell the poor guy working graveyard at Rite-Aid who fills your child’s antibiotics at 2am that. Tell the BS’s in the crowd that the PharmD’s are “harder working” and see where that gets you.

I know this is a big source of contention for you, but I have no problem at all calling them “Dr.” At least at my school..aside from teaching, the profs are clinical pharmacists who do a hell of a lot more “pharmacy” as opposed to retail pharmacists who spend more time dealing with insurance issues.

Son, I’m going to have a heart to heart talk with you. You are going to piss off /a lot/ of retail pharmacists with an attitude like that, so change it right now. Regardless on how you view the world from your wool-pulled-over student eyes, you will have to deal with retail folk, and belittling them by saying that they are less than “clinical pharmacists” is going to get your ass hung out to dry.
This is beside the point that when the public thinks of “pharmacy” they think of the retail guys who give their children antibiotics and prevent medication errors.

Many of them left retail not because they couldn’t cut it, but because they were sick of the retail experience and wanted to actually use their education.

That sounds like “couldn’t cut it” to me. I thought they went through residency programs? Why (for all of their “harder work” than us retail folk) would they settle to be nothing more than pill vending machines and insurance agents? Why don’t they go and work in a hospital to put their “clinical skills” to work rather than sit there and recite the same bullshit year after year to student after student?
I think a real “clinical pharmacist” does a whole helluva lot more than just sit there and talk for an hour to a bunch of students from stuff that they could just read in a book for themselves.

I’ve shadowed and had several experiences in the hospital with these professors and pharmacy residents who do have relationships with doctors and who actually make therapeutic decisions that the doctors listen to. They go on rounds and have full clinic days in addition to teaching.

Gold star for you. I’m proud that you set this old retail pharmacists who has never ever worked in a hospital (do you ever read my site?) straight. Because we all know that us stupid retail folk NEVER EVER make any therapeutic decisions and NEVER EVER do ANYTHING that would have anything to do than what we learn in pharmacy school. We’re nothing but just stupid pill counters.
When your testicles finally drop, and you get your shiny diploma and license, think of me as you are getting screamed at by the attending because you gave someone atenolol with a CrCl of < 20 instead of something like metoprolol. Because us retail folk know nothing of that sort. Our PharmD's and state board licenses are obtained via crackerjack boxes unlike yours which is granted upon thine holyness by the great god of pharmacy himself. However something makes me think you'll be working retail after you get out. Having an entire school of uppity "clinical" students tends to sap out the clinical jobs quite quickly.

As if teaching is automatically the fall back option when in reality retail is the fall back option. They actually use pharmacy school knowledge…it’s not a “fart in the wind” to them. The teaching hospital that our school is a part of employs over a hundred pharmacists. It can serve as a model for what pharmacy could be. I know all this is not the norm by any means, but if pharmacists can’t even respect other pharmacists then how can we ever expect MDs to?

*sigh* I’ll let the other retail folk rip you a new one. I’m too tired to tell you how stupid you sound.
I respect all pharmacists, however its fun to sling shit at each other once in a while to stir the pot.

Maybe it’s just my school, but my professors don’t sugarcoat the retail experience at all. They tell us how much they hated their retail experience and why. They tell us that it would be great to sit down and perform MTM, but the barriers are large. On top of that, The majority of our class has or has worked retail. We are fully aware of how shitty retail is in real life.

I’m glad your professors give you unbiased information. How would they know about ‘retail experience’ if they are all ‘clinical pharmacists’? How would you know anything about pharmacy by just being a student? Why dont you go formulate your own opinions about things like I do vs having them spoon fed to you by the faculty of your school.
My post was not “how shitty retail is”, its that what pharmacy schools teach you is NOT what the real life is about. Maybe if you would actually READ the entry before you spout off your holier-than-thou “clinical pharmacist” attitude crap you would of gotten the picture. Retail isn’t crap, its what the population thinks of when they hear the word “pharmacist”. Like it or not, we are the backbone of the profession and will always be the backbone of the profession.
I’ve worked as a “clinical pharmacist” and to be honest, I’d rather stand for 9 hours and actually socialize with my patients and their families than be some doctors bitch up on the floors of the hospital. I’m a person, not a fucking interactive drug book. Retail guys are furthering the profession of pharmacy so much more than the “clinical guys” because more people interact with us, we are accessible to everyone, and we’re everywhere!
If you would of read my post, you would of gotten that one of the major points (other than the “couldnt cut it”) is that most professors have not worked retail for a while so they have no idea what its like on the “real world”. How can a professor who works only floors at a hospital have any sense as to what retail pharmacy is like vs the guy who has been doing retail for 20+ years?

As a response to Nicole…in almost all cases there isn’t time to sit down with patients. However with the integration of MTM and diabetes-ed services into certain retail chains and the new changes to Medicare D there is an opening for retail pharmacy to move towards allowing actual counseling to happen. Did you know all those techniques for talking with patients IS actually used in the clinical ambulatory settings? Soo…maybe it isn’t all BS. However, if we all as (future) pharmacists continue to keep saying that this will never happen and continue calling all of this BS, then it won’t.

Make sure you make FUTURE pharmacist quite clear, because you are spouting off shit like you have been in the trenches for years. Damn PharmD CANDIDATE (hahah! I hate that word).

Maybe the reason doctors are so mean to you on the phone is because you’re a bitch. I’ve talked with and clarified scripts with more friendly doctors and nurses than assholes.

HAHAHAH I cant wait until you get screamed at by a doctor and end up crying in the pharmacy. Maybe your preceptor will hand you a tissue between giggles. Oh wait, you’re smarter than that stupid retail guy that just ‘settled for’ his job. Or maybe when you make that suggestion to the doctor and he totally shuts you down you’ll get the idea. Getting a script clarification is easy, getting something changed when the doctor has his mind set on something is a completely different story.
Pass the boards first and get your degree before you start throwing shit around, you just look like an idiot.

I know I’ll get flamed for all of this by the retail pharmacists who read this for being too idealistic and for not even being out of pharm school yet, but I’ve seen what pharmacy can be. My retail pharmacy (that does over 400+ scripts a day) has MTM, diabetes ed, flu immunizations, and other counseling sessions that people pay for. I’ve seen first hand the impact and the role that pharmacists can play in the clinical setting. It CAN happen, but if we keep denigrating our own profession and our own colleagues it won’t.

Your retail pharmacy? Son, you have no retail pharmacy and by the way you threw shit at the retail scene up there, what are you doing settling for a retail job anways? I hate to break it to you, but most retail outlets do all that diabetes/immunizations crap too. Of course we are expected to help people manage DM, to council and answer their questions and to give injections. Its part of the job, so don’t think your shit smells any better than ours because we have been doing for years.
You have NO idea how much you are going to get flamed by the retail guys. I really think you should stop visiting this site, because you obviously take stuff obtained from THE ANGRY PHARMACIST as the gospel of pharmacy.

Yay, moral hate mail!

The entire tirade about retail pharmacy is here

My last comment…the one I’m sure will draw fire, is regarding the
Birth Control Pill argument…. I am on your side that moral and
religious believes should play no role in pharmacy dispensing…
Refusal to dispense based upon those things goes against everything the
healthcare industry stands for (do no harm, yada, yada)… But I must
have read 15 comments you’ve posted over the past number of months that
all relate some story of a ‘vicodin addict or loser’ trying to get an
early refill or pull one over on you… Let me ask you…. What
percentage of vicodin (or pick your drug…I won’t go the route of
mentioning your personal favorite) prescriptions do you fill? Of 10
that you get, how many are legit in your view and you agree to
dispense? Does someone’s appearance play a role in determining that
script’s validity in your eyes? Some of your comments on the person’s
smell, clothing, hygiene all seem to imply that you do…. Is that a
‘moral judgement you’re making’? One person’s street drug is another
person’s morning coffee and cigarrette. The only difference is that one
is illicit and therefore hard to get, and the other is has entire store
chains devoted to it….(Starbucks…?)

First off, comparing a moral objection to dispense birth control vs refusing to dispense vicodin thats a week too early isn’t even an argument.  Its even stupid to even start to compare them.  How can you even start to equate “You know, God says that abortion is wrong so I refuse to fill your pills.. MURDERER” to “Uh, you just got 120 vicodin from another doctor 4 days ago, I’m not filling this until you are due”?  One is a 100% your own personal opinion and the other is doing what the DEA mandated our job to be (not to mention a huge safety/health/do-no-harm issue).  To answer your question, of those 10 Rx’s I have a pretty good assumption that at least 7 or 8 are being diverted (does everyone need Vicodin, Valium, AND Soma?).  However can I do anything about it? No. Why? I have no proof that there is, and there is that chance that they aren’t being diverted and actually used. So if they are on time, I dispense it without question.

So would you call someone who “loses/gets stolen” their vicodin Rx at least 3 times a month, always calls in 10 days early, doctor shops and is on every ER’s “do not dispense” list an addict?  Is that a call of morals like refusing to dispense Plan-B or a good statement of fact that you need to keep an eye on this person.  Its not even a moral call but a ‘get-you-head-out-of-your-ass’ call.

The personal appearance argument is vague at best.  I look at every Rx with a huge grain of salt especially if they are a new patient or an out of town patient/doctor.  I’m just as quick to call out doctor shoppers if they are a long-term patient or someone i’ve never seen before.  You know why? Its my job. 

Never in my career have I ever said “you know what, you look strung out and I think you are on way too much of this.  I am going to refuse it for no good reason other than my own”.  It doesn’t work that way.  I have however refused to refill based upon “Uh, if you take this how you are taking it, you are going to blow out your liver from 10 grams of tylenol a day, let me call the doctor”.  Thats a safety issue, not a “moral judgement”.

Judging by the rest of your comment, I doubt that you work retail.

An interesting tidbit of real-life info for those pharmacy students out there… One of the sucky part of my job is having to monitor diversion in a large setting… We use many tools to do this in order to track patterns.

Ah, I was right.

Everyones a Fucking Genius

So I got some hatemail in response to this entry

They may be corporate assholes, but at least they hold nobel intent.

Nobel intent would be charging a fair price for /all/ generics. Not $4 for amoxicillin yet $40 for a month supply of lisinopril or HCTZ.

People are dying; antibiotics save lives. No company *has* to give this type of break to anyone since the parasitical lobbyists from healthcare industry have penetrated both aisles of Congress. Yet they do.

Actually inappropriate use of antibiotics kill people (MRSA? VRE? VRSA?). Maintenance drugs that cost pennies will save more lives than all of the antibiotics combined. Why aren’t they giving all those away for free?
You’re right, no company /has/ to give this type of break however it looks really, really good for business if they do. Plus guess what, if you transfer all of your drugs there for 2 or so drugs at $4, you get to pay 10x what an independent charges for the remaining 5 of your Rx’s. Bait-and-switch. Bend over and grab your ankles. They are making up for the loss somewhere.

Get over it.
And when a universal coverage system hits, get over it too. You may have to put your new Porsche up for sale and switch to a Honda (get a hybrid and you can save the environment and maybe someone’s health, all that the same time).

Nah, myself and all the other pharmacists will be out of business at that point. We’ll determine that the cost of our schooling outweighs our income and we’ll just all do something else that makes money. Then as the pharmacies start to dwindle, the ones remaining can charge whatever the fuck they want or just refuse to serve you. Then what? You’ll just bitch that pharmacists are a bunch of greedy bastards because they don’t wish to work for free to fill your trade name Coreg for $1.50 profit.
Oh, I dont drive a porsche. I think fancy cars is just pissing money away. I prefer to spend all my money paying taxes so welfare folk don’t have to work and for this website so you’ll have something to bitch about at work.

If you wanted to make money, you should have went to work on Wall St not a place where reimbursements have been dwindling for years. Did you think that was going to change?

You think money is on wall street? I should of opened a PBM and started raping the system a long time ago, however anally raping the sick and poor isn’t really my cup of tea. Maybe to you wall street types its okay.

You’re a self-loathing narcissist; get over yourself.

You’re just a retarded douche who has totally made an ass of himself in front of a few hundred pharmacists.

N.B. I have been reading other comments on here and it’s somewhat nauseating. I think, instead of rx’ing myself Zofran 8mg tid I’ll go with Phenergan 25mg q4-6h off the $4 menu. Where’s your pharmacy.

Zofran is pennies now. Its generic, so yes, I will be Rx’ing myself some Zofran because it costs about the same a Phenegran and doesn’t have all the sedation side effects. My pharmacy however does not have a $4 menu because we charge a fair price for /all/ medications, not cheap out over a few to draw people in to rape them on the other ones. Fair prices and good service, like all pharmacies should be.
Plus what does my post have to do about anything that you are ranting about? Did you even read my post? Let me recap because I know I used some big words.
My rant was about these pharmacies giving away free/$4 generics away setting a precedent to the insurance companies to cut our reimbursements due to the fact that if we can get by selling things for $4, then obviously their reimbursements are way too high. They are fucking it up for the rest of us who cannot afford to sell medications for $4. Its a marketing scam and its going to draw the opinion of all the major PBM’s to make that AWP-30%+1.50 sound like a wet dream.
Wait to see how many pharmacies are left when the PBM’s make all the reimbursements $4/rx, and next time read my damn post before flaunting your ignorance.