Just Questions

Posted by The *Angriest* Pharmacist as Just a question, Lazy People, Management, Me being a dick, PSE, Rude, Stupid People, Work Sucks

Every day I ask myself questions. Most are rhetorical…but they are pertinent questions. I will share these with you now. Feel free to comment with some of your own. OR Check Out Pharmacy Chick’s version of this same exact thing from February 2008.

Why do old, toothless people always appear to be chewing on something?

Why is it than if someone is walking to my pharmacy, I can predict with 99% accuracy that they want to buy 12-hour Pseudoephedrine?

Why is it that someone that wants a script filled 10 minutes before closing will have had that prescription for no less than 7 days?

Why does the person wanting a rare, expensive C-II drug come to my pharmacy each month wanting it only to find out that I still don’t have it and won’t order it for them unless they fill it with me once and wait for the order to come in?

Why does someone on Medicaid give me their card only to ask me to “just fill it for cash” — knowing full well that I’m going to bill it to Medicaid FIRST?

Why is it that people think they need Watson brand Hydrocodone/APAP? Nevermind - I know the answer to this one…more street value cause it can be identified by pill-heads.

Why does every person that I would idenfity as a drug seeker use “I have fibromyalgia” as the excuse for their early refill or other behavior?

Why does every complaint go to a non-pharmacist store manager rather than to me?

Why does every doctor’s voicemail message have the same bullshit message that I can’t skip over (they can press ZERO to get to me!)? “Leave the patient’s name, date of birth, drug name with spelling, strength, quantity, last fill and pharmacy call back number.”

Why do people have to ask for the pharmacist to give a refill number?

Why will people have pizza delivered to their home in an hour and be happy with that wait time but want their prescription in 15 minutes or less?

Why do people want name brand drugs then be completely happy with store brand soda, chips, water, clothes, and everything else?

Why would someone present a prescription for a child then refuse it when the copayment is anything more than free?

Why would someone call me a ’stupid fucking cocksucker’ during one trip to the pharmacy then yell at me during their next trip when I use the word ’shit’ in front of their child?

Why do I have to concern myself with HIPAA when any patient would be willing to yell, “Yeah my name is Fred Jones…3-14-51. Doctor Smith called in my Viagra refill this morning”?

“Sir, are you taking any other medications?” No.
“No OTC meds?” No.
“No Vitamins?” No.
“Any herbals?” Nope.
“No other medicines at all?” Well, I’ve been taking this Saint John’s Wort for depression.

Why is the answer always, ‘NO’ to “Do you have any questions for the pharmacist” only to have the patient call the pharmacy back in 10 minutes later?

There are 24 hours in the day. Why does everyone have to spend their 30 minutes in the pharmacy on the cell phone?

Why does every patient with a new insurance card present that card at the cash register rather than the pharmacy drop off window when the read the sign that says “Please present your insurance card when you drop off your prescription”?

Why is it that 1 out of every 100 patients feel the need to poor their pills out on the counter and count them right there in front of all of us?

Why do Americans have the words, “I want to talk to your supervisor” into their brains for use at the first sign of a problem, dissent, friction, or trouble?

Why is there a direct correlation between the number of items in a person’s shopping cart and the likelihood they will want them rung up in the pharmacy?

Why is there a direct correlation between the number of scripts filled in my pharmacy and the amount of alcohol I ingest every evening? Nevermind — I know the answer to this one too…

Why is there a direct correlation between a patient’s lack of teeth and oral hygiene and the likelihood they will present a medicaid card?

Why do I have to be the person to explain to some people that BEER cannot be paid for with Food Stamps?

I have a feeling this post has instant classic written all over it…

More sins? What’s next - cheap prescriptions?

Posted by The *Angriest* Pharmacist as --Not Pharmacy--, Management, Me being a dick, Money, Politics

In case you were unsure beforehand, you *are* going to hell. The Vatican just solidified that in stone by adding a few new sins.

• Environmental pollution
• Genetic manipulation
• Accumulating excessive wealth
• Inflicting poverty
• Drug trafficking and consumption
• Morally debatable experiments

Let’s talk about them for a second. Environmental pollution — new age sinning created just for those of us in the 21st century. Gideon’s Bibles anyone? What about making birth control “wrong” as the church has done? Doesn’t that contribute to overcrowding and pollution? Sure it does. I wonder if burning witches contributed any to the greenhouse effect? Heck, it could be the cause! Witches in the atmosphere could be what Al Gore is trying to expose here…

Genetic manipulation — this is a load of bullshit. I wonder if monoclonal antibodies fit in here? What about the cancer that God allowed someone to get? It’s a manipulation of a gene. Is someone that gets cancer a sinner - or is just the cancer going to hell? What about the delicious corn I had for dinner last night? It was manipulated to grow bigger, faster, and more delicious. Is the corn a sinner, or am I a sinner for eating it?

Accumulating excessive wealth — wow. “Don’t get money, but if you have it, go ahead and give 10% to the church and we’ll absolve you.” Holy shit - what if someone wins a lottery? What about a high stakes bingo game? — that the church held? Michael Jordan is a sinner for being loaded - just because we paid him to put a ball through a hoop…What about Bill and Melinda Gates — arguably the most generous donators of all time (Microsoft stuff withstanding). What about me? I make a healthy wage - some would call it excessive. It’s obviously more than I need because others have less and do fine. Of course, we knew I was going to hell. I wonder what the GDP of Vatican City is…

Inflicting poverty — I’m not even going to list the number of people this makes a sinner…including the church. Of course, they’ve helped billions…but how many fathers died in the Crusades (any of them) leaving wife and son in poverty and/or servitude? What about me - having to charge hundreds of dollars to a patient for lifesaving therapy? Or the drug company charging my wholesaler an arm an a leg for that drug? Or even the PBMs gobbling up all the profits from every direction and, in a way, making us all just a little bit poorer?

Drug trafficking and consumption — I looked this one up for clarification. It includes consuming any drug that has a mind altering affect. You’ve got to be fucking kidding me? Not only is every person in America a sinner, I am the Harbringer of Death. Alcohol, caffeine, Xanax, opiates, Barbiturates — if it breaks the blood-brain-barriers, the Vatican says, “NO!” And trafficking? Again - talk about pointing a finger directly at me…SHIT! Next point - let’s make alcohol a sin, but continue to gobble it up during service, at the beer wagon during the school carnival, and any other time we see fit. It’s only a sin if you drink more than the Catholics do…if you drink less than they do, you are a pussy.

Morally debatable experiments — Whoa. Think about all the pertinent medical research that won’t get done now because some zealot sitting on an IRB will read too much into this, consider risks more than benefits, or just not even listen at all (as Christians are so good at doing). Now, I’m not defending research that consists of “let’s stop this heparin drip and see how long it takes a clot to develop in various patients” — I’m defending research that I don’t understand, know that’s going on, or may/may not involve some part of a zygote (don’t even type the fucking word fetus on my website - I’ll snap. Fetus = 8 weeks+ Which is why I could care less about dispensing Plan B…) Regardless — this is going harm medical advancement for the years to come. I wonder if this refers to private bedroom experimentation between the sexes? I mean, come on…we’ve all *ahem* Nevermind. Let’s just say that this may be targeting certain sexual preferences…not like the church would ever do that….would they?

Overall, I feel cheated that I have more ways to sin and find my way into Hell than those born in the 19th century. Why do those horse riding fools have a better chance than me of getting into heaven? Bogus. More importantly, can I get any ex post facto leniency here? Doubtful. I’ve got all kinds of purgatory headed my way — don’t I?

NOTE: Before commenting, read the URL of this website.
NOTE 2: If you post one fucking word about the prescence or absence of an almighty, I will be the one doing the smiting. I’m not looking for theological discussion on this site. I just merely wanted to bitch a little about these new rules some people have to play by that don’t make and damn sense, are somewhat hypocritical, and don’t apply to me cause I don’t give a rat’s ass.

Thundercats are go…

How to get fired from your job

Posted by The *Angriest* Pharmacist as Insurance Companies, Management, Me being a dick

Apparently, all you have to do is talk shit about them on the internet.

It’s a damn good thing the entire internet thinks my first name is “THE” otherwise I would’ve been fired for my transgressions a year ago (first post was Feb 07).

This is retarded. I’m sure there was something in a contract somewhere saying you or your employees can’t talk shit about our service on the internet. But, seriously, how many non-pharmacy personnel read these Pharmacist Blogs?

How many people are going to say, “Well, I’m not going to buy Express Scripts insurance because a semi-anonymous poster on a website said their helpdesk was unhelpful to the pharmacist!”

Once again — give me a fucking break.

Walgreens spins the hell out of USA Today’s Article

Posted by The *Angriest* Pharmacist as Management, Update

By now, everyone in pharmacy world has read the USA Today article that I critiqued and ranted about in this post: http://www.theangriestpharmacist.com/2008/02/12/finally-now-they-may-listen/

As expected, CEOs everywhere shit their pants and saw their stock investments drop in value all day long. You can check the stocks on WMT, CVS, and WAG — their values over the last five days have dropped one-half or so points. I’m not sure the effect the article had on it, but I’m betting it might’ve had something to do with it. Of course, the markets are going to shit right now, so that could be it as well….

Anyway, you know the CEOs had to get the spin out to their pawns in the trenches. Here’s what Walgreens CEO Jeff Rein sent down to the pharmacy staff:

To all Walgreen employees:
Some of you may have seen a USA Today report in today’s paper about prescription errors at major drugstore chains. Unfortunately, Walgreens was included among the pharmacies highlighted. Any time a story like this appears, my biggest concern is that it will scare patients away from using medication that, in many cases, is life saving. I’m also concerned it unfairly portrays the work of our outstanding pharmacy staffs – and the efforts we make as a company – to ensure patient safety and provide them with the best care. For example, the story didn’t focus on the many positive initiatives the industry has made to ensure safety and promote pharmacists as a key part of the health care system.

I’m sure many of you will get asked questions about the story, whether it’s from family and friends, patients and customers or business partners. To help you answer those questions, I’m including some talking points at the bottom of this email. (Please remember that any questions from reporters should be referred to our Corporate Communications department.) In the meantime, I can’t say enough about the tremendous effort all of you make to improve our patients’ health. Every day, I hear great stories about how you’re making a difference for them.. Thank you!

Believe me, although the national news media may not recognize the care you’re providing, it’s very much recognized by everyone within our company and by our tens of millions of pharmacy patients.

Jeff Rein
Chairman and CEO

TALKING POINTS FOR FAMILY, FRIENDS, CUSTOMERS AND PATIENTS REGARDING THE USA Today REPORT:
* We’ve been in the pharmacy business for 107 years. No one has better systems or processes for filling prescriptions than we do.
* Regardless of whether a pharmacy technician is putting the pills in the bottle, a pharmacist checks and verifies every prescription before it’s dispensed.
* In the last 10 years, we’ve invested nearly $1 billion in pharmacy safety systems, safety training and new technology. That investment proves how seriously we take our responsibility to be error-free.
* Walgreens invented the electronic prescription 15 years ago. Electronic prescribing is a powerful tool for eliminating errors associated with handwriting, and we encourage its adoption by doctors.

So, what’s wrong with his points for discussion? Let’s start with point one. I think saying no one is better than you is conceited as best. Think your infallable Jeff? Ask Sears and Roebuck…Believe me, there’s lots of people with better systems than you. I worked at Wally World for a bit — and their system is better than yours. I worked at Walgreens during my first year of pharmacy school — I quit after one semester because my experiences sucks so bad. Upgrades? Maybe. But, Walmart’s technology blows yours out of the water. Your shit might as well be PDX compared to Connexus.

Point two is null and void. Pharmacists can be idiots. Techs can be idiots. Just because a pharmacist checked a tech doesn’t mean it’s right. I’ve read studies saying that techs checking techs is just as accurate as a pharmacist checking techs. Do I think that’s the right course of action? Hell no. But, it is an interesting thought. Sometimes, it might be worth it to just suck it up and hire more people. But that’d cut into profits now AND later…

Point Three? Bogus. 1 Billion dollars? Yeah right. Your profit last year was 15 billion. I seriously doubt you dumped 1 billion of that into training and your software. Why not take that billion and put it into staffing? I guarantee you that’d do more for decreasing errors than increasing your PRODUCTIVITY - which is what he’s trying to say.

Point four is an act of deferral. Placing the blame on the doctors rather than your substandard staffing and increased workload. See point 3.

Finally - Now they *may* listen

Posted by The *Angriest* Pharmacist as Management, Work Sucks

USA Today has posted an article titled, “Speed, high volume can trigger mistakes.”

Check it out: http://www.usatoday.com/money/industries/health/2008-02-11-prescription-errors_N.htm

Then, some fucking idiot with 2 years experience in the trenches rebutted. I hope he gets stuck at a store that fills 1000 a day rather than his 80/day haven.
http://www.usatoday.com/money/industries/health/2008-02-11-prescription-errors-phillips_N.htm#uslPageReturn

Finally, we have an experience [retired] pharmacist tell it like it is:
http://www.usatoday.com/money/industries/health/2008-02-11-prescription-errors-kennedy_N.htm

Hopefully, CVS, Walgreens, Walmart, RiteAid, and the other big players will pay attention rather than merely rebutt with the bullshit “our pharmacists are expected to make professional judgement prescriptions and are not required to meet any quotas.”

Yet, they refuse to offer additional staff or hours. If I’m expected to fill 250 in a 12-hour day BY MYSELF…how can I do anything but fill as fast as possible (and potentially make mistakes)? You think I can stand there, take an Rx from someone and tell them “it’s going to be 3-4 hours before it’s ready. Give me a fucking break. Once they call my DM or my HQ, you can bet they’ll be in my store the next day listing reasons of why I’m wrong, how I can work faster, how I don’t need additional staff, and an ultimatum: Fill faster or we’re going to make your life a living hell.

And what can I do but fill faster? The patients aren’t going to give a shit about my time constraints or professional judgement. They want 15 minutes are less. Hell, a pizza takes 30…but you want me to deliever controlled poisons faster…eat shit.

Pharmacy Skewls? Idiots!

Posted by The *Angriest* Pharmacist as Education, Management, Me being a dick

I just got an ANGRY ass email from a student at that fuck-stick-of-a-school, St. Louis College of Pharmacy. The 2nd year student was absolutely livid about some curriculum changes which he thought unecessary. It goes as follows:

Current 2nd year student: 300 Required IPE (Intro to Pharmacy Experience) hours
Current 5th year student: 65 Required IPE hours

Holy shit….what a jump! Now, why would the school mandate such a change? Well, it’s all because their accreditation councils (Accreditation Council for Pharmacy Education) has mandated the change. Of course, without hesitation, the school has jumped through the hoop.

I remember my IPE days…they sucked. They were worthless. These are not to be confused with my APE’s though….those were absolutely flawless, necessary, educational, and pivotal. However, IPE? Not so much. My first IPE found me working in a hospital. I followed a pharmacist around as he did nothing…all damn day. I did this one day a week for nearly two months. Granted, I had to make one presentation about the benefits of an injectable Zyprexa. I learned a bit there. The rest wasn’t worth a shit. My next year’s IPE found me working at a retail pharmacy that was slower than molasses. I did nothing. I learned nothing. All I did was spend several hours, one day a week working as a fucking technician for some pharmacy. It was a waste of my time. I would have rather been in a classroom actually LEARNING something. I was also required to do some community service. Doesn’t that fucking contradict the point of community service? REQUIRE COMMUNITY SERVICE? What a fucking oxymoron! My pharmacy school should be slapped in the face for such bullshit.

Anyway, the point I’m trying to display here is that IPE’s are worthless…or at least they were for me. My school’s system needs serious revamping before they could ever implement some bullshit like this. Apparently, StLCoP is the same way. I dunno for sure. Either way, quadrupling the number of hours, pushing them to the summer break, and making them even more worthless, does nothing for our students and future pharmacists.

I hope StLCoP makes their IPEs challenging and educational. Otherwise, all they’re going to gain is a semester of bored students, no-shows, and pissed off pharmacists who signed up for a student pharmacist and ended up with a hungover pile of pig shit.

Happy Freaking New Year Indeed

Posted by The *Angriest* Pharmacist as Management, Me being a dick, Stupid People, True Story, Work Sucks

I hope everyone went to get their prescription today. New year, new month…I NEED MY MEDS TODAY…NAY — NOW!

The Angry Pharmacist had a bitch of a day.

My day wasn’t so bad. We went crazy on staffing, and that helped a ton. I had myself, another pharmacist, a full-time cashier, two techs, and a pharmacy student who is on Winter Break still…so I didn’t do so badly.

I also had a hell of a time with assfucks who don’t understand what a deductible is and why they are paying full price. Obviously, their pharmacist is ripping them off right? Give me a freaking break.

I also had a lady come in and want me to rerun scripts that were filled on 12/31/07. She was the dumbest person ever and paid cash for them — over $200. I asked them why they picked them up if they were so expensive. The response? “We didn’t know they were that expensive!” What???? Listen Motherfucker - I have your receipt. It says you paid cash — $200 worth of bills. You knew damn good and well. Now, you want me to rebill them with today’s date? That’s illegal. That’s fraud. But, again…the pharmacist is ripping them off. Like I need to take your $200 bucks and put it in my pocket.

I went as far as getting their Medicare plan on the line and have THEM tell them that it was wrong to do that, illegal, and that they should have known better than to pay for them since they were in the donut hole. But…whimper…they were poor and couldn’t afford that…they happened to have 200 bones on their person though…

I didn’t give them the answer they want - so what’d they do? They ran to the fucking store manager. He came back and asked me what was going on — in front of them. They stood there and snickered “aww this mothuhfuckuh is gonna get it now” — Wrong. He came to my little window. I said the following, “The Pharmacy is my domain. If someone ever comes to you with a pharmacy problem again - you’d better find a way to send them back. Tell them you have nothing to do with the pharmacy and no control over it — which you don’t. If you continue to run back here like you are going to right a wrong, I am going to make your life a living hell. You will find yourself in this pharmacy 150 times a day getting consulted on every little decision I have to make. You know nothing of our protocol. You know nothing of pharmacy law. I’ll call you if I need help stocking the OTC or running the register. Other than that…butt out.” [I had fire in my eyes at this point.]

He turned around, looked at them and said, “Sorry, I can’t help you all. The pharmacy is a separate entity of the company. I thought there was an error with the register. You’ll have to talk with the pharmacist to get this all straightened out…”

Fucking. Burn. Note: I learned this tactic in a comment on my blog, Pharmacy Mike’s, or perhaps it was UN_PC_Rph — I’m not sure. Either way, it worked flawlessly. Kudos!

Anyway — I ended up just rebilling it with today’s date and refunding their money. Illegal? Yes. Ethically the right thing to do considering they really couldn’t afford it? Probably…So, the ends justified the means…and it got them the hell out of my pharmacy. They stole 45 minutes of my time…I did let them know the favor that was being done and how to not make the same error in the future…I wasn’t a dick about that though…

Hope everyone else had a decent day…

Thought Provoking Comment

Posted by The *Angriest* Pharmacist as Management, Me being a dick, True Story, Work Sucks

I got this recently from the Quilt Lady — who is a long-time reader:

Hey TAP,
I endured a gruesome 14 hour shift Friday, the worst coming from a female customer who DEMANDED that I price match her 90 VICODIN to $6.00 because the pharmacy mgr said he would. It’s against my better judgment to PM controls, but this woman was incorrigible so I said I would call another pharmacy to check their price ($12.49). She DEMANDED to speak to the store mgr. (obviously she thought he would overrule me), and I smiled and called him to the pharmacy. When she got done complaining about me and my attitude, the store mgr. TOLD ME TO FILL THE Rx FOR $6.00. I explained the rules… but an argument ensued between he and I. He convinced the woman to just buy the Rx for $12.49 and come back when the pharmacy mgr was on duty. HE THEN APOLOGIZED TO HER FOR MY ATTITUDE. I was dumbfounded!
My reason for writing is this… I would like to ask you to run a poll on price matching, especially on controlled substances. I want to know how my fellow colleagues across the nation feel about this practice.
You don’t see Physicians and Attorneys price matching… why should Pharmacists?

This goes right along with the shit that I and Pharmacy Mike have been raising hell about of late — having your nuts taken away by upper management with no control over pharmacy or knowledge of pharmacy law. I’m glad I don’t have any issues like that to deal with anymore…If I did, I’d throw my weight around and they would cease to exist. Who do you think a company is going to want to keep more, a pharmacist or a manager that can be replaced with any other person with decent experience in the store? Pharmacists are too hard to come by — especially in my area. The problem would be gone soon.

If I were you Quilt Lady, I would have completely lost my shit on the store manager…laid it all out there about how s/he had completely removed all your authority in a situation where the manager had none, given positive feedback to this “I want to see your manager” bullshit that Americans pull every day to get their way, and apologized for something you didn’t do (and wouldn’t be sorry for even if you did). I would have asked him/her why he thinks that’s necessary, where he got his authority over my pharmacy, and when he was going to give me the $7 he cost my pharmacy. He’d tell me he was calling my DM and tell him I was rude. I’d tell him I’m not being rude, he’s just an insignificant piece of shit when it comes to my pharmacy. Problem solved.

Tell your manager to go suck on a pork sword…I put up a poll for you - we’ll see how it turns out…hopefully, we can get a good turnout on it - New Years Resolutions didn’t turn out so great…

Tip: When some asshat calls upper management on me. I get the ear of the manager first. The walk to the pharmacy, I interrupt the patient and pull the manager into the pharmacy and into my bathroom. I tell the manager the entire story. I tell her why I am right, what the patient is going to say, and why they are wrong based on ethics and the LAW. I tell the manager that s/he has no say in the matter and the case is closed. However, to appease the person, s/he may give her a gift card or something, but that will come out the manager’s bonus should they wish to do that. They’ll do it the first time — but as that shit continues and the positive feedback is given to the manager-calling-customer, it also gives negative feedback to the manager. Eventually, a balance is reached. The balance is that the manager will butt-the-fuck out and let me run my own fucking pharmacy like the law, my company, and God herself intended…

I’m really easy to get along with once people learn to worship me….:-D