Lengthy Reply to an Ignorant Commenter

Posted by The *Angriest* Pharmacist as Hate Mail, Me being a dick, My nose itches, Stupid People

Most of you read my recent post titled, “The last day I’ll ever be questioned.” It was a pretty aggressive piece of writing. I went complete berserk on a member of my front-end staff for defending who I called a, “Scumbag.” I received a range of comments — some applauded me for standing up and telling the front-end staff to butt out. Others didn’t agree with the ferociousness with which I went after him but agreed with the overall message. Then I had one jackass who took the opportunity to attack our profession, calling it a trade and a vocation. Here is my rebuttal. I hope he returns for round two.

Mr. Old Fashioned (REMOVED) aka N., a 28-year old from REMOVED [IP Address REMOVED] says, “Simply put you are a pharmacist NOT a doctor, NOT a DEA agent, and certainly NOT an elected official charged with the care of the public. Your job is to decipher a Dr’s handwriting and dispense what you are told in the proper dosage. Most people in your craft today are being replaced by computers because apparently a trained chimp could do the job just as well. You like to put yourself on some higher plane thinking that you are a member of the medical field when the extent of your knowledge can be obtained by the reading of a PDR. You are in a customer service based industry. It has always been a customer service based industry. Only through the bastardization of the industry by power hungry idiots who couldn’t hack it in real medical school has it become anything more. You have been given “POWER” by the DEA to judge people you have never meet and impose a sentence upon them based on 0 fact or evidence. On nothing more than your gut feeling that this man was a “Scumbag” you decided to refuse him service. And if you can even say with a straight face that you would have treated Little Miss Blue Hair the same way I applaud you sir, you should think about politics. Keep your double standards and you Napoleonic Complex to yourself and get back to servicing the customer that pays your friggin check. You are not some shining light of justice and righteousness. You my friend are a bean counter, nothing more. I respect the fact that you were “Doing your job” but it is high time that you and others in your field of vocation learned what their job is.”

Let me begin by saying you are a very ugly man. This is compounded by the fact that you are a WoW Fag. I would like to thank you for reminding me that I am not a doctor or a DEA agent. Thank goodness! I was confused. Frankly, I have too much common sense and ethical obligations to be a Doctor. I’m not clean cut enough to be a Fed. However, I am charged with protecting the public as well as caring for those that are too unintelligent or inept to care for themselves. The Combat Methamphetamine Enforcement Act essentially laid that job at my feet. Forgive me for wanting to protect our streets from the viscious methamphetamine epidemic. It is my job to police this shit — as much as I don’t like it. The law is the law. Albeit a technicality, if a chipped license allows me to keep a mass-PSE-purchaser from getting one more box to throw in the trunk, so be it. If enough of us “stupid pharmacists” enforced the rules rather than focus on making a buck, we could be a real thorn in the side of those manufacturing this junk. However, the way to really cut this shit down is to make it Rx only, as I explain in the link above.

Now I’d like to address your claims that my job is to ‘decipher a doctor’s handwriting’ and that ‘most people in my craft are being replaced by computers’. Let me explain this, PART of my job is to decipher doctor’s handwriting. Most of my job deals with something called Drug Utilization Review (DUR). This means that I review your past medicines, disease states, allergies, and demographics to make sure that they drug you’re getting is just perfect and safe for you. Sure, the computer can check for interactions. It can tell when you could be allergic. Example: You are allergic to Penicillin [cause it gave you a *laugh* bellyache *laugh*]. After I talk with you and try to explain that a bellyache isn’t an allergy, it’s a side effect, you still don’t want to take Amoxicillin your doctor prescribed [cause he didn't know they were related at all]. I call him, and he wants to know what drug would be an appropriate switch and safe for you. I, of course, find out that you have an Upper Respiratory Infection and suggest a Azithromycin 5-day pack. He concurs, and we all go about our day. When exactly do you plan on writting the 50 million lines of code that can teach a computer to: A]Recognize the DI and attempt to explain to the patient about the difference between and allergy and Side Effect. B]Shutter in disgust at a patient’s idiocy (still knowing that the crossover between Penicillin and Amoxicillin is ~3% — so, if you got hives, we give it to you. If you got anaphylactic shock, we don’t.) C] Call the Doctor and wait on hold for 10 minutes until someone answers. D]Explain the situation to the doctor then make a therapeutically sound change. I’m sure you’ll get right on that after this next round of WoW, right?

I’m sure you like to think I’m ‘putting myself on a higher plane’ merely because I work in healthcare. But the fact of the matter is, I am on another level. I’m not some asswiping nursing-student. Also, a “PDR” as the public likes to refer to so often is nothing more than an ad-rittled piece of shit. If you pay enough money, suddenly your product is the Drug Of Choice — regardless of what the standard of practice is. I use pages of the PDR to light campfires. If you want a good reference book, go buy Dipiro (But, it is written at graduate level, you likely wouldn’t understand most of it). Go buy Briggs for Pregnancy and Lactation. Go buy Sanford for Antimicrobial therapy. Go buy Remingtons for Pharmacy Practice. Go buy Harrison’s.  Go buy something by Koda-Kimble — she’s the endall source for Therapeutics/Clinical Pharmacy. You get my point yet? PDR = Shitty crap made available to the public to make them think they are smart by looking up Lupus.

Customer Service Based Industry? Fuck customer service. I have patients. What the patient wants isn’t always what’s best for them, their health, or others. The patient is NOT always right. If I always did what a patient wanted, I’d be breaking federal law most of the time. Sorry that Walmart and it’s do-whatever-for-the-customer attitude has skewed your view of the REAL world, dude. My actions have consequences.

It’s cute that you think that every pharmacist is some idiot that failed out of med school. I bet you think every doctor is some schmuck that couldn’t make it through veterinary school as well. Fact of the matter is that I went to pharmacy school out of high school. It was my first choice. I agree that our big pharmacies are really having detrimental effects on pharmacy by giving away antibiotics and selling some prescriptions for $4. But, you thinking that people failing out of medical school have done this is really off base.

I don’t ever judge my PSE buyers by their looks. Hell, some fuckwad could be buying it for his sickly girlfriend. I don’t know. I judge them by their past history. No one needs their limit of 24-hour Sudafed every month for a year (on three consecutive days) from my pharmacy and the one next door (which turned out to be the case with that dude — I found that out since I wrote that Post). Normal people don’t just walk away quietly when they are denied a sale because they already bought their limit for a month (Because we aren’t abusers — we don’t ever hit our limit). Normal people don’t buy 2 boxes one day then another the next day, “just to stock up.” I buy one box when I’m sick — and it lasts me a long ass time. I judge people by their actions — not by their looks. I’m not always as petty as you would want me to be. My evidence is in the books — Cold. Hard. Facts.

Little Miss Blue Hair gets the same scrutiny — I know for a fact my store sold Sudafed to a little old lady who was buying it for her nephew to use to manufacture meth. Our PSE logs were used in the case against them. He used her to go around to pharmacies, thinking she would not be questioned due to her appearance. However, for lil old ladies, I usually call their doctor and tell them about the use of liberal PSE and the effect of it on hypertension…especially in little old ladies. I’m a nice guy and don’t want my PATIENTS stroking out.

I’m 6′3″ — I don’t have or need a Napoleonic Complex. I leave that to short, fat fuckers like you, Shadowzfell. I exert my authority when it is what is best for my pharmacy, my patients, and occasionally, my bottom line. For what it’s worth, the ‘customer’ as you so retardedly call them, don’t pay my check. My company does. They make their money from a variety of things from OTC, to beer, to birthday cards — even some various holding companies. They’ve had to broaden their income sources due to the ‘bastardization of pharmacy’ as you so eloquently put it. Pharmacy is quickly becoming a cost center rather than a profit center due to decreasing payments from insurance companies/PBMs and increasing costs from our drug manufacturers because of their various endeavors (i.e. Big Titted Drug Reps).

I may not be a shining light, but believe me, one day you’ll be thankful that a pharmacist was there for you to have access to when no one else was available — At 2am when your 4-month old is coughing, running a fever, and your pediatrician just won’t return your call even though you’ve called the exchange 5 times! You’ll call Walgreens and some old pharmacist will help you through it, maybe even give you the dosing for your childs age/weight. You’ve cursed us before, you’ll praise us then. Or when your kid is 16 years old and beginning to experiment and try new things. Some new friend got his hands on some Oxycontin 80mg cause a senior had a forged prescription. Your child takes the pill, but she bites it first. Her friend said the buzz would be better. By cracking the time-release coating she screws up the release mechanism and gets all 80mg of oxycodone at one time. She dies a few hours later of hypoxia due to respiratory depression. You’ll wish a real person - a license pharmacist - had looked at that prescription rather than the 50 million lines of code you wrote.

Believe me, a pharmacist is much more than some old bastard that counts by fives. That’s part of it. That’s not it. Hopefully, I’ve expressed some of that in this post. I didn’t go to school for 6 years and earn my doctorate in pharmacy to learn simple 2nd grade math. I learned diseases, pharmacology, mollecular mechanisms of action, treatment algorithms, monitoring parameters, primary literature evaluation skills, biostatistics, pharmacoeconomics, etc. etc. etc.

Finally, pharmacy is not a vocation. It’s not a trade. Pharmacy is a profession. It’s high time that you (and the rest of the ignorant public that think like you) learn that fact. Pharmacists are the most respected and trusted practicioners in the healthcare field. Day in and day out, doctors refer to pharmacists for help in treating their patients. This is more evident in the younger generation of doctors, as pharmacy has really advanced in the last 10-15 years. The profession has gained steam and medical schools have acknowledged that. They have taught their students that we can be trusted, relied upon, queried, and respected. In many states, pharmacists are allowed prescriptive authority in collaborative practice with physicians. Even more, some states allow pharmacists to apply for DEA Licenses allowing them to prescribe controlled medications. Almost every state allows pharmacists to give vaccinations to children and adults alike.

If need my car fixed, I go to a mechanic. When I need a leak fixed, I call a plumber. These are skills. These are vocations. I cannot do them. I am not qualified to even begin to attempt in doing them. If a mechanic or a plumber screws up, people cannot (usually) die as a result of incompetence. I’m not saying that these men are less of a man than me. I’m not saying they don’t deserve my respect and admiration — they do and they get it. But, people’s lives do not hang in the balance. Plumbing and Mechanical work is a respected trade, but it is not a profession.

Believe me when I say, PHARMACY IS A PROFESSION. Professional people working in a professional setting to help patients get the best results from their pharmaceutical therapy with the least amount of side effects and adverse events.

If you think like I do, feel free to send REMOVED an email telling him all about it.

Let this also be a warning — Don’t fuck with an angry pharmacist when your e-penis needs a little lengthening. You won’t win.

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