Below, I'm going to post several different things that came to me via email or the CONTACT link. I'll lead with the user's name, and if you wish to reply to one, just reference that name....or don't...I don't care...

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Liz writes:    In the past few weeks, our pharmacy has started checking ID for controlled drugs, scanning in new Rx and scanning in hard copies.  All of a sudden, our workload has tripled, but our company is cutting tech help.  Is anyone else finding this hard to manage?

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Rodney writes:   I work as a reimbursement specialist at an LTC Pharmacy, and I'm writing to share an interesting exchange I've had with representatives at Prescription Solutions over the past few days.

I've had a few basic rejections which, were the representatives at Prescription Solutions even modestly intelligent by today's decidedly low standards, should have been able to resolve with much rapidity. Instead, I got stuck with slack-jawed yokels and embittered, defensive inner-city youth. They turned requests for overrides to simple rejections into drawn out, unintelligible arguments, and once they'd been cornered or otherwise became bored with the exchange, they hung up on me mid-sentence.

I may not be the bubbliest person in the world. On the contrary, I'm frank and to the point, but never did I become enraged, and never did I insult or otherwise disrespect the reps in any way. Prescription Solutions - hell, the insurance industry as a whole - has no shortage of stupid, rude, and disinterested people, but I've never had any with the gall to abruptly hang up on a service call. Now, over the past two days, it has happened to me four times.

Though I feel somewhat vindicated by the fact that return calls yielded exchanges with intelligent reps who applied the necessarily overrides with absolutely no hassle, I am perturbed by this sudden shoddy treatment. I know PS has seen extraordinarily long hold times as of late, what are the odds the reps have been granted free reign to terminate calls from "problem callers" (that is, of course, callers who question the rep's ill-informed initial judgment)?

Any thoughts? Similar experiences?

[TAestP's thoughts: I believe the reasoning behind this is, as always, money. When the question is, "Why?" most of the time, the answer is money. In this case, I'd bet if you timed your calls, you got hung up on at specific intervals....something like 3 minutes, 59 seconds. If the agents keep their calls (or a certain percentage) less than 4 minutes, they probably get higher ratings or a bonus at the end of the day. They may also have rewards/cut offs at 10 minutes or 15 minutes. Of course, the person could have just been an asshole, accidentally hung up, or hung up on you because they are lazy and/or didn't know the answer.]

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Lillian writes:     I found your blog a few days ago and I love it so far. From your posts, you seem to know a lot about retail pharmacy so I was wondering if you could answer a question for me: Is it true that the field is getting very saturated, very quickly?

A few of my professors warn us that it will be much harder to find a job in retail by the time we graduate (2016). And I've been hearing a lot of people saying that retail is going downhill.

I know there will be more competition for the jobs in several years because of there are more students going into pharmacy now. And I get the feeling that maybe one of my professors is exaggerating the situation to encourage us to go into other pharmacy fields. But do you think this saturation is something to be seriously be worried about?

For the record, I would try to go into retail no matter what the situation is...I just don't want to be completely caught off guard after graduation.

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Kristin Writes:
Dear TAestP,
I know someone who filled a Rx at a CVS.  The pharmacist later called and texted her saying "Remember me from CVS?  Would love to get coffee with you some time?--Weirdasspharmacist [sic] "  She responded that she wasn't interested. She didn't get any more fills there, but she was afraid of contacting his manager or pharmacy baord because CVS had her information on file and the pharmacist could look it up and perhaps do something scary like stalking.

TAestP, what would you recommend doing?

[TAestP's thoughts: If this is true, it is creepy as hell. You are right that CVS would have the info, and he would have access to it. But, he's already pretty much risked his license by doing this -- taking it from creepy to full on stalking would definitely result in a meeting with his state's Board of Pharmacy. If he is not the pharmacy manager at that location, I would call and speak with the pharmacy manager about the incident. Tell her it made you (or her) uncomfortable and that you would like the manager to give your information to their district manager so he/she can call you at their earliest convenience. Then discuss the matter with the DM. I'd be almost anything this would squash absolutely any issue -- cause that DM does NOT want you making a formal complaint with the board. If he is the manager at that store, call a nearby store's pharmacy manager and do the exact same thing. If this does not get you to an ends that you are happy with -- or you get blown off at any level -- google the state's board of pharmacy. One call to them with an accusation like this would definitely result in an investigation and something would be done. Tell your friend I'm sorry my text creeped her out -- she's not gonna like the photos I'm sending tonight....just kidding of course.....:-D]

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Mike writes:   so...i witnessed a patient ingest 90mg of methadone...the patient's prescribed dose was 40mg...i gave him the wrong bottle

i'm getting kicked out of pharmacy school 4 months before graduation...what do i do now?  should i submit my resume to the nearest McDonald's?

[TAestP's Thoughts: Either this is untrue and you're trying to waste my time, you're just a general dumb ass,  or you have done a ton of other stupid bullshit.  Regardless of what anyone may think, there is only one person responsible for what pill goes out the door and into the hands of a patient -- the pharmacist on duty. I don't care if the technician accidentally typed in Oxycodone instead of Omnicef for an infant, I still believe the ultimate responsibility should lay on the pharmacist that verified the prescription. (intentional bullshit and other types of lying and deceit aside -- I'm talking about true accidents by ancillary staff not caught by the pharmacist)   However, it does sound like you are in some other kind of facility or setting. Since you witnessed the patient do it -- not sure what that means as a patient should never be handed a pill by pharmacy staff to take -- that changes the role from dispensing to administering which we cannot do (in terms of pills).

If the school threw you out, and this is a true story, you're probably fucked. Sorry dude. I guess you could appeal and plead to the school, but that's the thing with private universities, they can do whatever the hell they want whenever the hell they want. Other than that, see if another school will take you or get a lawyer....or get a job and good luck paying back all those loans....]

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That'll do for now....check back for the next post coming soon....

Had a lady call me for a refill (on we'll say 3/19) on her (surprise) Norco 10/325 last week because she was (surprise) going out of town. It had been 9 days since we had refilled it. The prescription was for 50 tablets taken every 6 hours. I put it in as a 13 day supply. I told her that it would be "a few more days" before it could be filled. She, of course, did not agree with me. She tried to tell me that it was a 12-day supply and we, meaning my pharmacy, "always fill it three days early." Well, she's wrong...maybe two days early...on a 30 day supply...if the patient isn't a problem....

The fact that she argued with me about filling it early, about it being a 12 day supply versus a 13 day supply, and told me what MY pharmacy always does got me interested in her profile.

I booted up my trusted internet browser and navigated to my state's Prescription Drug Monitoring Program, plugged in her information, and I was quite shocked at what I found.

Date                        Drug                                       Qty/Days    Prescriber   Filled by:
3-14         Hydrocodone/APAP 10/325     90/30          J. Smith          CVS
3-14         Alprazolam 1mg                               90/30          J. Smith          CVS
3-10        Hydrocodone/APAP 7.5/325    50/13          B. Jones          MY PCY
3-10        Alprazolam 0.5mg                           30/10         B. Jones          MY PCY

And this shit continued for the last 3 months or so. Let me share the most SHOCKING piece of information -- there was another column titled "Payee" which will say Medicaid, Commercial, or CASH. Usually, we would expect this to say CASH at one pharmacy and COMMERCIAL or MEDICAID at the other when we encounter doctor shoppers. In this instance, THEY ALL SAID COMMERCIAL!!!

This lady was doctor shopping using her insurance card...from her benefits at work! WOW! I can only assume the insurance company didn't catch it because the strengths had different NDC -- maybe even different manufacturers? Not sure....

I called and confirmed all of this with my friend Remy at CVS, and we each canceled all of her refills. I then printed all of this out and faxed it to the physicians involved (and every pharmacy in town). I heard back from both offices very quickly -- and they were pissed. They canceled the refills (of course) and each fired her as a patient.

When she called back the next day, it was precious. She said, "Well, will it go through today? It's been 10 days and it's a 12 day supply."   I said, "No, it's still a 13 day supply, and it has come to our attention that you have been getting the same drugs in different strengths at CVS."

"That's just not true!"
"Oh, yes it is. And this has been going on for several months now."
"Well.......(long, awkward pause)......how do I fix this? I'm not sure I know what's going on...."
"Well.......yesterday, I fixed it by faxing this information to both doctors and every pharmacy in town. The doctors then called me back and canceled all remaining refills and wanted me to let you know you were released as a patient. Now, what they are going to do? I don't know. For your sake, I would hope they don't call the police because it appears crimes have been committed here..."
"Eck..." [Really odd sound she made here. I'd say it was the sound of disbelief.]
"If you really and truly have no idea what's going on, you need to call and talk to CVS and both of these doctors immediately...." [I said this in a really shitass tone]
"Okay. Thank you very much!" [Being nice...praying *I* don't call the police]

The title of this post really says it all, amiright? If you've worked in service of customers/patients, in any field, some jackass has uttered (or hollered) these words in an outlandish attempt at getting their way by bartering all of their money for future services rendered in exchange for instant gratification in the form of (most likely) you compromising your better judgment.

Obviously, this has happened to me quite recently...and it pissed me off royally because I was the nice guy being lied to and this fat bitch was the fat bitch that altered her prescription and lied to a(nother) pharmacist.

She presented a prescription from a doctor for that read as follows:

Pt: Janice Sanveritas

Hydrocodone/APAP  5/500
Sig: 1-2 tabs po q4-6h prn pain.

Dr. Ima Schmuch, DDS

Now, most reasonable people can see that this prescription LACKS A QUANTITY. She brought this to me at, we'll say 1pm on Sunday. After I IMMEDIATELY pointed out that it lacked a quantity and would require a phone call the next day, she remarked that she thought that this was the case, but she convinced herself that the word "SIG" which was scribbled was in fact the word SIXTY. Of course, this would be ridiculous because it is very UNcommon for a dentist to write for SIXTY FUCKING VICODIN. So, we argued about this a bit and decided that she was mad at the dentist for not writing a quantity and not me, but she was pretty sure he told her sixty....considering this lady had been a problem in the past, I didn't care what she thought, I wasn't even gonna give her 1 or 2 for that night (which I might CONSIDER, for a second, if she was a consistent, good, nice, polite patient).

So, she left script in tow. She came back at about 3pm. Now, the script had a convenient #60 written in right beneath the Sig. The ink didn't match. The hand writing didn't match. The story made no sense. She told me the drove over to this dentist's office and caught him just as he was leaving and he apologize profusely as he wrote in that #60 in a different handwriting from 6 or 7 days prior. I called his office the first time she came in and of course, nobody answered. In fact, it went straight to voicemail as if no one were in the office. I left a message at that time, but I knew no one would get it until Monday. Luckily he was there, right?

I told her, right when she handed it to me that I was going to have to call and verify the quantity...and the drama and bullshit began. You all know how this went.

"I have to call and verify this."
"Why? He wrote the quantity in plain as day. You can see it right there."
"Yes, but you must understand why I have to verify this. It's Sunday afternoon. I've seen this script without a quantity and you bring it back and now it has a quantity written on it. If your dentist DID write this in, he should have called or at least initialed next to the quantity that he wrote it in a different colored ink. He knows better. He knows how things are these days with all those druggies out there."
"Ohh so now you're calling me a druggie?"
"I don't recall saying that specific phrase. Did I say that?"
"Well, you might as well. I'll tell you what I'm fucking sick of this place. Every time I have fucking problems because you're a fucking idiot. I'm NEVER COMING HERE AGAIN!"
"And that's completely fine with me. I just want you to at least accept that you know where I'm coming from. I have to verify that quantity on that script. You've had it for several days. What's 18 more hours? I can call in the morning before I even open."
"No, just give it back to me. I'm going somewhere else. This is ridiculous. I've been coming here for 10 years. [Note: this pharmacy has only been open for 4-5 years] I'm going somewhere else, and I'm transferring all my meds away, and I'm never coming here again. Someone else would be more than happy to accept my business."
"Okay...fine...good bye" [and good fucking riddance]

-=+=-

I wanted to say, "Do you really think, for one second, that I'm not going to call every pharmacy in town the SECOND you walk out of here and let them know that you are leaving here with a prescription that I believe to be altered?"    But, that would ruin all the fun of wasting her time! I WANTED her to take it to another pharmacy -- or several if possible -- only for her to be turned away for the EXACT same reasoning. I also wanted to write something on the prescription, but that would've also kept her from mustering up the gaul to take it elsewhere.

So, I took to calling all 8 pharmacies in my vicinity. Turns out this fat bitch was already BANNED from Wal-Mart, a Medicap, and a Medicine Shoppe.  Now, she can add one more pharmacy to that list for her bullshit.

The winner of the "where this bitch ended up" contest was CVS. I'd talked to their pharmacist Remy, and she politely called me back. She let her drop it off and return 30 minutes later. Remy told her that the quantity's ink did not match the rest of the prescription and that she had no choice but to call the next day and verify it. This bitch politely said, "Okay, thanks a lot!" and putted her ass right on out of there...after showing her ass real good right in front of my eyes!

Today rolls around and I head in there and first thing call that dentist's office and apprise them of the situation. I told them that I believe that she modified the prescription, but CVS currently possessed the hard copy and would be calling. I just wanted to tell them my side of the story. Their side of the story? He intended on giving her 20 tablets and was nowhere near the office on Sunday.

Cut ahead to Remy calling me later on...She verified the script was altered by someone, and the DDS intended on 20 tablets. However, he went ahead and AUTHORIZED TWENTY TABLETS TO BE FILLED! I could not fucking believe it. Remy couldn't believe it. Hell, the fucking patient probably couldn't believe. This was the only doctor in the fucking NATION that would approve that script. He is enabling her addiction -- no doubt about it. This fucking doctor is a problem. I am debating whether or not to call the Board of Pharmacy and the Board of Medicine. I'm not sure if there's grounds for any sort of investigation -- or if I would just end up looking like a tight ass, punk pharmacist...

What are your thoughts?

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My name is Steve Moore and I am an independent pharmacy owner from New York.  I am wondering if you would consider sharing your thoughts on the following topic, one I think that most pharmacists would be interested in.

When it comes to business side of our profession, most pharmacists don't have a clue as to what is going on.  As an owner, it affects me more than most, and I don't comprehend all of the complexities.  After speaking to some other pharmacists in my area, I came to realize that they are under the impression that mail order pharmacies were simply discount pharmacies, that mail order just filled prescriptions at a lower price than retail pharmacies.  That may or not be true, the larger issue is that mail order pharmacies are able to offer deeply discounted medications because they are purchasing medication a better price than retail pharmacies.  PHARMA grants them a special class of trade (COT).  I attempted to find a law/rule/etc that grants mail order pharmacies these special buying privileges as a different COT and was unable to do so.  I wrote to consulting companies and wholesalers and I was told that there is no such list.  If there is no government approved or provided COT list, what makes mail order special other than the fact that PHARMA says so?

My question is, if mail order can do it, why can't community pharmacy designate itself as a special COT?  Mail order promotes safety and accuracy, we have a robots and workflow too.  We can fill antibiotics and pain meds, mail order cannot.  We can deliver meds the same day, mail order cannot.  Mail order simply cannot meet 100% of our pharmaceutical needs.  If any group deserves a price break from PHARMA, shouldn't it be the group that can meet more needs?

There is a federal law known as the Robinson-Patman Act which specifically prohibits companies from selling the same products to competitors at different prices (order of magnitude wise).  Exemptions to this act exist to allow nonprofits (such as hospitals) to purchase medication for their own use at a discounted price.  In addition to the hospital COT, there is a 340b class (for now), a long term care class, and depending upon who you ask, anywhere from 7 - 23 classes.  The one constant is that the retail pharmacy COT pays the most for medications.  COT designations have been challenged in the past but were usually lost on the basis of own use.  That meaning, the nonprofit was purchasing medications to use for its patients/employees/etc and was not in competition with retail pharmacies.  Mail order pharmacies are for profit and are clearly competing with retail pharmacies, so in my mind a Robinson-Patman exemption should not apply.  I understand supply and demand and that some people can pay more than others for the same product, but we are not talking about a few bucks here and there, rather exponential differences.  The local hospital pays about $9 for 100 tablets of brand name Coumadin, what does the price sticker on the bottle in your store read?

The fact that mail order pharmacies are buying  medications at a lower price than retail pharmacies has an impact on every pharmacist filling 90 day prescriptions at retail for mail order rates.  I am not saying that if reimbursement improves, working conditions will improve, but it can't hurt to make pharmacists aware of what is going on.  I have contacted our trade associations and industry publications but am also reaching out to bloggers such as yourself.  If you feel that this may be something you would like to blog or post about, I can provide some links and references.

Thanks for your time.

I've also had a recent brash of problems with patients being rude/uncaring about the difference between requirements of a pharmacist versus services provided by a pharmacy. Some things we do are required by laws, federal or state, while some things are done to ensure patients have a good pharmacy experience and return with more pieces of paper.

Requirements:

1. I take the prescription from you. I ensure it meets all legal requirements (Name, Date, Drug name, directions, quantity, refills, doctor signature, and in my state, the Rx symbol on the face of the prescription).
2. I input in the computer (the computer system is not required. I could use a typewriter or even hand write the labels).
3. A prospective DUR (Drug Utilization Review) is performed by either the pharmacist manually and/or the computer system automatically ensuring that there are no drug-drug, drug-disease, or drug-patient interactions requiring concern. If there is, the physician in contacted. The patient is educated or the drug is changed to an alternative at this point. If there is no problems, we move on:
4. A label is generated and placed on an amber bottle.
5. The appropriate drug is counted and placed into the bottle.
6. Final check is performed by pharmacist and all aspects of the process is verified again. Finalized product is bagged and put into the pharmacy's WCB (Will Call Bin).
7. Patient picks up medicine. Patient is provided the opportunity to ask a pharmacist any questions concerning the medicine with the magic question, "Do you have any questions for the pharmacist?" -- this requirement not being added until 1990.

Services:

1. Billing your prescription insurance (or Medicaid) for the cost of your medicine (I don't have to take any insurance - let alone YOUR insurance). Some compounding pharmacies refuse to accept insurance and are cash-only.
2. Calling your insurance if their is a problem such as them not wanting to pay for the expensive name-brand drug your doctor wrote for, the quantity he wrote for, or for any of millions of other reasons they could dream up. Perhaps you remember when CVS made the decision to not call your insurance for problems any more. They accomplished this by placing a phone in the waiting room. It didn't go over well, but it proves my point.
3. Calling your doctor for refills when your prescription runs out. This is the job of the PATIENT that has been performed by pharmacy's striving to merely keep patients from having the opportunity to take their pieces of paper elsewhere if they are forced to visit the doctor for refills.
4. An easy open lid is placed on your bottle instead of the safety lid which is the legal requirement. (Screw your arthritis - I don't have to cater to you!)
5. Paging your name overhead when your prescription is ready -- that's all southern hospitality, buddy!
6. Taking checks or credit cards is also optional. Cash is the only requirement -- read the dollar bill. Does your credit card or check say that I *have* to take it? Nope.
7. Flavoring your child's antibiotic with out FlavorRx system.
8. Anything or everything related to having a drive-thru or providing services through it.
9. Being nice to you in any way, shape, or form. I just have to be there and be sober...I don't have to be my normally delightful self...

I'm sure this second list has a BUNCH more items on it. Fill in the holes for me...I'll add them to the list.

I recently got an email from someone giving out tips on how to ensure pharmacists have the best chance of busting the scam-artist. It all makes complete sense, but it may not be things that we would think of in the spur of the moment.

I've reposted the "scenarios" below with the permission of the author, but I have edited them somewhat to make them more clear/applicable. My thanks go out to the author -- Michelle.

-=+=-

Suggestion 1: Someone brings in a fake prescription. After they leave, you call the doctor and verify that this is a fake prescription. The office confirms that it is fraudulent, altered, or illegal for whatever reason and instruct you to not fill it and have the person arrested. So, you call the police, and they tell you to notify them when the person arrives and stall the scammer when they come in to pick it up. You wait until they show up. Here's a tip: tell your employees that when the customer walks into the store and announces their name, NOT TO STARE AT HIM LIKE HE HAS THE PLAGUE!! Your behavior gives you, and your intentions, away. Scammers will pick up on this -- noticing the attention and bolt.

Suggestion 2: The patient will call you to see if their prescription is ready. All fake scripts will be called on by the scammer first to "test the waters" depending on your (or your tech's) response here dictates whether they ever come in. DO NOT ASK "What exact time will you be here?"  RED FLAG. Under normal circumstances, you wouldn't care what exact time it was picked it up. If you ask, the person will know that the police will be there to meet them, and he/she won't show up. This will remove the gratification you so desperately need to see the person leave your pharmacy in handcuffs.

Suggestion 3: Don't tell them over the phone that they shouldn't use the drive-thru. Scammers know it is easier for you to arrest them in the store, so when you tell them"Uhhhh, just come in the store, something is wrong with our drive-thru," or "We need you to come in the store to sign something," they will know you are lying, and they won't show up. Another thing about this that will backfire is when they do show up and the supposedly broke drive-thru is full of customers.

Suggestion 4: For the purpose of this suggestion, we'll call our prescription forger Sally Smith." If you work in a big chain, you have lots of customers. They know this -- that's why they frequent the busiest stores. You cannot possibly know all your patients by name immediately. So, let says Sally Smith walks into your Walgreens at 11:00am with a fake prescription for Xanax. She gives it to you and leaves. You call and verify that it is indeed a fake prescription. You alert all of your employees that when Sally Smith comes back in they are to call the police. You and your employees anxiously await Sallys arrival. Did Sally show up yet? Watch for Sally to some in! Well, Sally has been at this for awhile and before showing up, she decides to call you and see how you react on the phone, most often zealous pharmacists give themselves away when trying to get someone arrested. Its 3:00pm. Sally calls Hello, my name is Sally Smith. Is my Xanax prescription ready yet? If the pharmacist immediately responds with Um, YES! It is ready She immediately knows the jig is up because you knew who she was without checking the Will-Call-Bin or the computer system. What you should say is, Sally who? What's your birthday? Okay. Hold on. Let me check.....When did you drop it off? Oh, yes, Sally, yea thats ready for you. This is much more believable. If they sense anything, they just won't come in -- they can just forge another one and drop it off somewhere else.

Suggestion 5: Someone comes in with a prescription that you suspect is xeroxed. Medicare/Medicaid is slowly rolling out measures to counteract forging of prescriptions like watermarks, heat sensitive ink, and separate pads for controlled drugs. Anyway, you think its copied/altered. The customer gives you or your technician the prescription and leaves the counter but walks around the store pretending to be shopping. If you, as the pharmacist, are going to hold the prescription up in the air under a light like its evidence from a murder scene to see if it is copied, here is a tip, go somewhere where the customer cannot see you do this! They will be watching/waiting. If they see this followed by you grabbing the phone in an adulterous rage, they are going to bolt. In addition, go somewhere out of the pharmacy and call on the Rx. The patient might hear their name or see you say their name and assume you are going to find out it's fraudulent...and bolt.

Suggestion 6: If someone comes in late at night to fill a controlled substance, right before closing time, there is a reason. They know you cannot contact the doctor at that hour and you just want to go home so some pharmacists will just fill the prescription as is. Some pharmacists may decide to not fill it until they can call tomorrow and verify it. Just tell them that rather than give them the drugs or lie to them. And definitely don't blatantly lie to them by saying something like, "The pharmacist-in-charge already left for the night and took the narcotic key with them. I can't fill anything until she gets back tomorrow morning at 9am. You can come back then." These types of people have usually worked in a pharmacy or are very familiar with pharmacy workflow due to the frequency of their pharmacy visits. They will know that every pharmacist has access to the narcotic cabinet and just because one pharmacist leaves does not mean that narcotics cannot be filled -- how retarded does that sound? Turning away all prescriptions...yeah right! Assuming they are ignorant of the ins and outs of pharmacy is wrong, and it will keep you from catching them and seeing them punished for their crime(s).

-=+=-

The readers of this post are going to have varying degrees of opinions on this matter. We can all agree that is illegal, and we discourage it. Where we will have differing opinions is on what is done after the prescription has been determined as fraudulent.
1. Some will always call the cops.
2. Some will just tear the script up and tell the patient they know it was fake and tell them to not come back to their store (and make notes in the computer on the patient's profile).
3. Some will just write fake on it in sharpie and give it back to the patient when they come in.
4. Some will leave the script alone and tell the patient they don't have the drug and will give the script back to them.
5. Some will call the cops and have them come pick up the fake rx and make no attempt to have the person arrested in their store.
6. Some just fax the Rx to every pharmacy/doctor in their area and then give it back to the person and see what happens when they try and go to the pharmacy down the street.

None of them are wrong, necessarily. I am a big fan of Number 6. It's really quite humorous to hear the stories from fellow pharmacists when the person continues to peddle a forged Rx to every pharmacy in town, and they ALL know it's fake in advance.

Some employers refuse to allow their pharmacists to call the authorities or have an arrest made within the store -- as it might scar the store's reputation or bother the other customers/patients. I think this is a punk ass cop out. But, in this case, pharmacists are restricted to numbers 2, 3, 4, and/or 6.

So, what's the right way to handle the situation? What do you do? What have you done in the past? I realize that stories are sometimes pertinent to show what you have done in the past, but try and keep them short and to the point.

UPDATE!!!

Read the Fraudulent Prescription Writing Guidebook at:
http://deadword.com/site/stripmall/hogshire2/bottom.html
If we know the rules and tricks they pull, we can counter them.

Well, the man, probably used to being turned away, accepted his fate and slumped away. A few minutes later, he and one of our front-end assistant managers came back in a sort-of triumphant march. The look on Sudafed-Man's face was a I-got-you-now-motherfucker glare...as if this Assistant Manager was going to put me in my place.

"So, what's the deal here with this man's license." ~Dumb Ass. Manager [My tech conceded to me.]
"We no longer accept license that have a broken laminate. It's not a legal license, and it's a ticketable offense per our local DEA Agent." ~TAestP
"Well, that doesn't make sense to me. All the information is clearly readable and we'd accept this if he were trying to pass a check." ~Dumb Ass. Manager
"That's all well and good, but we're not passing checks here. We're selling a substance that is controlled by federal law and regulated by national legislation." ~TAestP
"I don't understand. I used it last week to buy some 4-hour Sudafed!" ~Sudafed Man
"Okay. I understand. This laminate deal just came to our attention very recently. How bout this. I'll sell you this box now, but from this point forward, it is the policy of this store that your license is illegal and will not be honored. You need to have a new one printed." [Then I glared at the Dumb Ass. Manager] "And you stick around. I want to talk to you for a second."

So, I made the sale. Then junior and I went into a secluded aisle.

"So, do you know what just happened here?"
"Well, I just..." [I cut him off here -- The crimson hue of my face should have told him to shut the fuck up]
"I'm sorry. That was a rhetorical question. I'm going to do the talking, and you just listen. Since you felt the need to come back here and defend a scumbag, you undermined my professional judgment. I understand that you accept that to verify checks. I'm not dealing with checks back here. I'm dealing with dangerous chemicals. Now, that man is going to take the dangerous chemical and make it into a VERY dangerous chemical by mixing it with a ton of OTHER dangerous chemicals and sell it for people to inject into their veins and get high. It's called methamphetamine.

You front end managers think you are doing people a solid by coming back here and challenging my decisions day in and day out, but all you are doing is causing MORE problems for me. You give stupid fucking idiots validation in their flimsy arguments against my professional decisions as the pharmacist on duty and the pharmacist in charge. You, by merely coming back and inquring, are saying that you and some fucking idiot are right and that I may be wrong.

From this point forward, you and the rest of your front-end staff are NEVER to come to my pharmacy and inquire about anything with related as to decisions I, or my staff have made. Your response from now on is the following: 'You are going to have to talk with the pharmacist on duty. If you don't agree with him you can ask for the pharmacist in charge or inquire about when he will be returning.' Even if I told a little old lady to shove a broom up her asshole, you tell people their only recourse is to talk to the pharmacist. You have no say in the pharmacy and you will get no say until you complete your doctorate of pharmacy in an accredited pharmacy school.

Are we clear?"

"Yes, sir. Absolutely." ~Dumb Ass. Manager

"Okay. Please pass this information on to EVERYONE else in this store that is not in the pharmacy....Good talk."

-=+=-

Now...That was fucking brutal wasn't it? You bet your ass it was.

I nearly made him cry, and I'm not shitting you all, that's almost word for word what I said to that poor bastard. And no, I'm not going to apologize or recant in any way.

That's once small step for a pharmacist and one giant leap for the profession. Never again will I let someone without R.Ph or Pharm.D after their name even attempt to question the policies and procedure I institute in my pharmacy.

"IF YOU ARE GOING TO BE ON THE FUCKING ROAD, YOU NEED TO FOLLOW THE RULES OF THE ROAD. STOP RUNNING FUCKING STOP SIGNS YOU STUPID BITCH"

She rattled off some inane babble about "did you see that red car right in front of me? were you watching that red car???"

I think she was implying that since she was tailing a red car very closely, that the red car's stop counted as her own. Readers, I can assure you that while, in theory, this sounds correct -- she is in fact a stupid, dumb bitch and needed a good kick in the cunt...which I would had delivered had I not be on a very important mission to get home and drink beer.

Attention bicyclists! I can accept your hippie ways. I can become accustomed to your unwashed hair and your vegan lifestyle for the betterment of 'mother earth' -- but, when you're on my fucking roadways, you obey the laws of the road you hippie scum. I don't give a fuck how much you are reducing your carbon imprint...or mine!

If I had hit that fat, pear-shaped slut, my ass would have been in trouble...not hers. The cops wouldn't have said..."Ohh she ran the stop sign...have a nice day!" They would have said, "You hit a pedestrian? I'll see you in hell, motherfucker!" Then I would have been locked up.

Stay on the sidewalk, off my roads, and off my fucking last nerve.

Next time I'm going to door-check that sperm-burping whore....

-=+=-

I hit a new personal record today. I received 20 NEW, PAPER prescriptions from an assortment of people in the 10 minutes before I closed for lunch. I had filled 50 fucking scripts up to that point. I got 13 from an elderly couple returning from vacation, 3 from a guy that I'll never see again, the C-II script above, 2 for a baby that mommy had been holding on to for 3 days, and 1 for a fucking ferret. Never filled for a ferret before, but I guess he deserves to eat up my lunch half-hour. I went to work on these people as the piled into a fucking line at my drop off. I convinced the old folks to come back in 4 hours (they wanted to wait...cocks), the guy I'll never see again would come back after lunch (he saw the hunger in my eye), mommy was gonna come back after lunch (she never did - poor child), the ferret was coming back in an hour, and the C-II was my only wait-er...We know how that turned out.

-=+=-

I complemented a lady today on how well behaved her two girls were as they waited for their prescription. They sat quietly talking to each other and bothered no one. Mom read a magazine and never even looked up at the kids. It was amazing. I couldn't believe how well 2 five and six-year-old girls minded so well. When their script was finished, I called them up, mom paid for her script, I told her how good her children were, and as they were leaving, one of those little sluts turned around and threw her sucker at me. It hit me in the throat and left a bunch of red gook on my nice white jacket. I hope that little bitch gets pregnant before high school.

I handled it well, though. I just said, "Hey! That wasn't nice [insert swears under breath]!"

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This middle aged lady brings in a box of Alavert-D to return it. She bought it yesterday, but meant to buy (read: waste her money) just plain ole Alavert. She had the receipt...but it didn't matter. The box was opened. Hell, there may have been a tablet or two gone.

"I'd like to return this. The manager told me that if you had a problem to call him..."
[I think it's cute the manager is trying to flex his nuts here. At the same time, I hate him for pawning this off on me...]

"Well ma'am. It's not really a matter of me calling the manager in this situation. I simply cannot return this product for a plethora of reasons. It's been opened. It's a controlled-substance now, and the main reason I can't accept it back is because it's against the law. Once a medcine leaves the pharmacy, I can't take it back."
[Here's where it gets funny. I usually allow the person to say something here - mostly to see what their thoughts are. If they even just say 'well I really wanna return it' I tell them that I'll do them one better...I'll give them store credit for the cost of the product AND let them keep it. Hell, I can't resell it. I can't do anything with it. It's a bitch to return - so I leave it with them.]

This bitch didn't even give me the CHANCE to give her the cake AND let her eat it. She got so huffed up she grabbed her little plastic back, snatched her receipt, and literally marched the fuck out of my pharmacy. And it wasn't a slow march - this bitch was moving. She was almost RUNNING.

I was taken aback. I kept my cool. I didn't call her a bitch, idiot, or any of the other words running through my mind. Ohh, I wanted too.

I just left her with one word, "BYE!"

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