Ah, you all know that I love a good hate-mail. 🙂

you’re all a bunch of ingrates. like WE’RE supposed to read your minds? ya’ll make a TON of money and have the nerve to have a power trip about it at the same time.

We don’t expect you to read our minds. We assume that you have enough common sense to realize the information that we need right off the bat so we dont spend an hour wasting our time to fill your Rx. I mean who goes anywhere without their insurance card? Do you drive without you drivers license? I realize that people forget stuff at home, but then demand that /I/ call /your/ insurance to get your ID number that /you/ left at home 5 mins away. No, thats not a power trip, thats respect for someone who is providing you a service. Next time you’re at the store and forget your credit card to pay for your food, whine at them because they wont call your credit card company to get your CC#.
I don’t see what making a ‘TON of money’ has anything to do with this. Yes, we get paid normally high wages compared to ditch diggers and waitresses, but they aren’t really responsible for your life are they? They didn’t to go college for over 5 years nor are saving your life when two doctors refuse to talk and prescribe the same thing.
I get high wages for my schooling and my knowledge of pharmacy. I don’t get paid high wages to be your bitch and errand boy because you’re too lazy to either call in Rx numbers or run home for your insurance card.

I’m sure this will either not get posted or it will and the indigent flames will then come…

I would of just glossed over this and blindly approved the comment. However I figured you shouldn’t get off that easy.

Wrong on many counts.
1. Family docs are well aware of the costs of the meds. We know which ones
are covered by the government for seniors, which ones require a limited use
code for coverage and which ones don’t have a generic equivalent. The
pharmacists don’t do that for us. If we don’t get it right we get a fax
from the pharmacy refusing the script.

Are you sure? Why do I see at least three times a day a doctor prescribing Levaquin to a known private pay patient. You know, the types that get pissed off because now they have to wait to get it changed because a 10 day run costs over 100 bucks. Yet when I ask “did you tell the doctor you didnt have Rx insurance” the response is “I sure did, he said it costs ‘about 30 dollars or so'”.
How about the rare times doctors themselves actually call in Rx’s, and say “oh shit” when I say “are you sure you want to prescribe that? Mrs Jones has no Rx coverage, and thats over 200 dollars”.
I call bullshit on your statement. You may know the cost of the medications, but ‘family doctors’ have little to know clue as to how much Crestor or Levaquin or Lipitor costs. Unless I somehow work in town full of retarded doctors (which I seriously doubt).

2. Docs get nothing from drug reps for prescribing their products. They’re
not allowed to leave anything more than free samples, so no one is getting
lap dances out here.

Riiiiiiiiiiiiight. You must live in a state that has those ‘free good’ laws out there. We have a clinic next door, and they look like santa waltzing in with bags and bags of free shit. They have paperweights, coupons, notepads, pens, etc, etc, etc. They come with their dinners and golf trips and vacations and on and on and on.

3. Some newer drugs have evidence behind them (meaning large-scale RCT’s)
proving that they work better. And some patients have had side effects or
poor response to the older ones. So not every doc prescribing the new med
over the old one is doing so with no therapeutic intent.

Did you read the studies? Or just listening to the reps who push them. The devil is in the details, and I bet if you actually sat down and read that clinical study (rather than just listening to a talking head), you’d actually realize that the glamor and hype whats news is just a rehash of something old and generic and cheap. Remember the first rule of Journal reading: See who paid for the study.

Rant away, angry one. But maybe you’ll want to step out behind the counter
every now and then and get back in touch with reality.

Dont have enough time too. Im too busy listening to your patients complain about their cost of their medications, answering questions about their health because ‘the doctor was too busy to answer this for me’, and giving explanations/excuses on why your office hasn’t faxed back my refill request/med change in 2 days.
Oh, you’re a Canadian ER Doctor (from what it looks like on your blog, i spent 2 min’s looking at it, so I might of missed something huge). Lets see how this changes things:

There seems to be a common theme among my hate mail:

well. You’ve hit my hot button.
There are people who are allergic to generic drugs Not the active
ingredient but the binders dye, glycerin, etc.
So are you going to stop counting pills and make up generics yourself?

Hate to break it to you, but 75-90% of the oral tablets are made up of the same binders. The only difference might be the dye, but how many generic lisinoprils are there? How many generic metformins are there? How many generic drug companies are there that all make the same product (Watson, Teva, QT, Endo, Ranbaxy, Roxane, Upsher, etc). If someone has a true allergy to a “binder”, then most likely they are going to have a problem with the trade name medication. Getting an “upset stomach with everything except brand name” sounds pretty psychosomatic to me.

did you ever stop to think about the patients who have trouble with certain
generics? Please don’t give that crap about how all generics are the same
as brand name. We in the medical community know that some generics don’t
work as well. It’s a good thing you aren’t running the world because if
you were someone would have already shot you.

Problems such as with the binders? The same binders that all other tablet manufacturers use? Plain (non XR/ER) tablet making really isnt rocket science. They all pretty much are done the same way for the lowest dollar. Clinically, how would you determine if a generic isn’t working as well as a brand name? Maybe the patient skipped days (you dont know that, you dont have their refill records). Maybe the patient doesn’t take his/her medication just so they can get you to write a DAW-1 on their next Rx. With the exception of drugs with a narrow therapeutic index, how can you really tell that Lisinopril isnt doing its job (or the patient just wants trade name and refuses to take the generic). If you find a generic that doesnt agree with the patient for some reason, switch to another one by another company. When it comes right down to it, and the cards are laid out on the table, the reasons why generics “dont work” is because “the doctor said so” (fueled by drug rep kickbacks) or purely psychosomatic reasons. Ive seen it with every single brand -> generic switch to date.
Amazing how generics magically work when insurance companies stop paying for the brand name and the patient is slapped with a $300 bill for the trade name medication they so eagerly bitch for.

This is going to be the last post about drugbuyers.com. I’m just going to point out a few points, paste a few hate mails, and leave it at that. I dont think drugbuyers.com administrators nor I want to deal with the aftermath of a full on flame war.
Here is where they say how much they love me
Points to make:

Jeezus H Christ ive been getting a lot of hate mail lately. Heres the latest from a real life doctor!
***NOTE***
I am friends with a ton of doctors. Dont take this as me bashing all doctors. Seriously, there are tons of shitty pharmacists as well as shitty doctors out there. However when a doctor writes what he/she said below (for no reason really, I havent said anything about doctors in a while) you know I cant keep my mouth shut.. 🙂 Plus im really sick and tired of hearing that we’re “wanna be doctors” (which we arent)

You pharmacists are real jerks arent ya? First off….alot of people that
are on medicaid are not all on welfare. Most of those people are the ones
who have pre-existing conditions that can not get private insurance or
insurance through a job!

Uh, medicaid = state assistance = welfare. They may have a huge Share of Cost on their Medicaid, but its still state assistance. Plus I hope you realize that im not against /everyone/ who is on the state tit. I see plenty of people who this really does help, my response mostly was about women who want to get pregnant when they cant afford to take care of themselves.

For example…I have a patient who is type 1
diabetic who uses a insulin pump. I script my patient humalog…my patient
calls and tells me the pharmacy is wanting 90.00 per vial for her insulin
and it was going to cost her over 450.00 for her 5 vials to last her a
month. I tell her to contact her local medicaid office and see if they will
give her insurance. They did…that same day! This woman works, goes to
school and has children but with her other medical conditions and other
scripts I write for her there is no way in the world she would be able to
take care of her family if she is not taking good care of her diabetes.

Bad example Doc. Type-1 diabetes is not a pre-existing condition that insurance companies will reject one on. Lets elaborate a bit further.

Angry noob,
Disability often begins on welfare then migrates to the longer term SSD. I know you dont know this since you have yet to walk yourself through it.

I never plan to walk through it. Plus, ask any pharmacist and you’ll find out that there are a shitpot more 25 year olds on SSD + Welfare than welfare alone.

Glad to see you looked up endo. Most doctors do know what it is, did you read they dont somewhere? The problem is getting diagnosed (surgery). As you can imagine, a woman going in with the symptoms of “pelvic pain” doesnt tend to raise a whole lot of red flags. Doctors often do nothing until one is totally disabled or infertile. But it is not because they dont know.

You saying that right there tells me that most doctors dont know what it is. If pelvic pain so bad that it makes one disabled, it tends to raise a red flag for something not normal. Chronic pelvic pain, or disabling pelvic pain isn’t normal. Obviously you and I have enough common sense to realize it, and we’re not “doctors”.

I think most any endo patient would agree with what I said to you. Point being, there could actually be a valid reason.
Lets say this was the case, it would probably be a hail mary as many women know after pregnancy things can get worse. But it all depends on what position a person is in at the time and how much education they have about it. Then it is personal choices which obviously are always up for disagreement.
Would be a pity if someone were to judge and make fun of someone in such a situation for choosing to try while they can with the hopes of it helping their condition as well as possible plans for hysterectomy afterwards to solve the problem completely allowing one to return to health.

However if you cannot take care of yourself (being on welfare) because of this. You are in no position to do a ‘hail-mary’ call as to if a child is going to fix you, or make you worse. Sure, having a child could magically fix you, but if it doesnt? Not only is your quality of life going to get worse because of your condition, but you are also bring a child into the world which you arent going to be able to take care off to the best of your ability because of a botched judgement call.
So you sit there, in disabling pain, watching your child grow up, unable to do anything or act as a ‘normal’ mother. You call this helping? I call it hell. I bet you like to sit there with a garden house in your hand as your house is burning down. Thats what it would feel like.
Sure you can have a hysterectomy afterwards and be done with the whole thing, but now not only do you have to be able to support yourself (you cant, you’re on welfare remember), but now a child. I’m in the camp that if you choose to reproduce, you best be financially and morally fit to raise that child to the best of your ability so it too can get a job, succeed at life, and not become a burden like most children seem to be now days.
If us (the taxpayers) are footing the bill for someones life, then I think we should be able to judge all we want. If she doesnt like it? Get off of welfare or dont have a child.

Let me spell this out for you
Hysterectomy is any womens best shot at ridding herself of endo, endo often causes infertility,
Pregnancy to have a much wanted child ->hysterectomy isnt as bad of a plan as
no hysterectomy/no hormones/hormone failure/surgery failures -> stay disabled for ten years until you cant have children anyways and then opt for the hysterectomy.

How about:
If you cant afford to have a child -> Dont have one
If you are unable to have a child due to a condition -> Dont have one
If you require outside medication to get pregnant -> Dont have one
If you have a good chance of not being able to have a child due to a condition, and having a hysterectomy would fix that problem rather than suffer for 10 years because you’re he-hawing thinking about reproducing (which you probably couldnt anyways) -> Have hysterectomy
Its simple. If you cannot afford something, you dont buy or obtain it. Its like being on welfare and driving escalades.. wait, bad analogy. 🙂

Im glad this gave your blog some more fodder, surely it will entertain someone.
Self proclaimed nurse.

Actually everyone is quite bored with this already.

Look what some smart-ass had to say in response to my entry about Welfare + Clomid = WTF?:

Ever heard of endometriosis? No course not, youre not a doctor lol.

Yes, I do know about endometriosis. I would explain it to you, but the words are too big for your tiny brain to comprehend. But to those out there, its a condition where uterine tissue grows in places that is not your uterine (in a really general nutshell)
Actually, most all doctors with the exception of OB/GYN’s and maybe oncologists wouldn’t know what endometriosis is. So you can ‘lol’ that up your ass.

If a girl had endo, which can be disabiling, I could see her point in
trying. 1. sooner the better 2. pregnancy often kicks endos ass. Becoming
pregnant used to be the main offerings for treatment but women who have
been horribly disabled by endo changed that.

What does this have anything to do with my post about people on welfare getting fertility drugs? In fact, this has nothing to do with the people wanting to have children when they cant even support themselves! Did you even read my rant before responding?
Let me spell it out for you:
I AM TALKING ABOUT WOMEN ON WELFARE WANTING FERTILITY DRUGS TO GET PREGNANT. I AM NOT TALKING ABOUT ALL WOMEN WANTING FERTILITY DRUGS, ONLY THE ONES THAT CANT AFFORD (meaning, they dont have the money) TO TAKE CARE OF THEMSELVES LET ALONE A CHILD. IT IS LIKE SELLING THE CAR FOR GAS MONEY.
However, since you can spell endometriosis (and are probably a self-proclaimed “Nurse”), i’ll give this another 2 seconds of brainpower. According to the standard treatments, pregnancy isn’t even on that list. In fact, im sure most women would rather be on some sort of oral contraceptive rather than bare/raise a crotch-fruit for 9 months + 18 years. Furthermore, since 30-40% of these women are sterile, why would they be taking Clomid? Not going to do them one damn bit of good except to waste money. Nature has a funny way of saying “maybe you shouldn’t have kids”. I think some women need to read the writing on the wall rather than trying to override nature and get some horrible burden they may not expect.

Anyways, mighty pharmacists dont know it all, which is why we have
doctors.

Uh, dig that hole a bit more sweety. I’m sure that there is a bit more you can do to completely make a total ass out of yourself.