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....

I've been working for [this pharmacy] in [the Southeastern USA] for many years (5+ let's say). Before that, I spent 12 years at Walgreens. Is there any legal issue in a company not allowing their pharmacists a legitimate, leave the pharmacy, timed, lunch break? Well, legally, it must not be, or they would not be so easily getting away with it. As far as I know, it is the ONLY corporately run pharmacy not giving a lunch break in the state in which I live. All the usual suspects, when it comes to these human rights issues, Walgreeens, CVS, Wal-mart, Sam's Club, provide lunches -- sometimes even within a CLOSED PHARMACY. Do you have any comments? How can I post such a question on your site to ask other professionals?

Well, you did it in the right way. Send your questions, comments or guest articles via the CONTACT Page and I'll see what I can do.

Anyway, readers, tell him what you know. Here's what I know. Pharmacists are sometimes listed as salaried management and therefore fall under different guidelines than your every day cashier, technician, or stocker. I'd bet my bottom dollar that is the case where you work. That's the exact story where I live. Fortunately, I'm able to go sit down, even if just for a few minutes to eat some lunch every day. Even if it's a scattered 15 minutes. I shoot for noon when I know the phone will slow down as the nurses are all out to lunch, and patient's slow a bit too -- at least the ones that have jobs. So, I woof down my lunch. If you can't do that, I'm sorry. Move to another store/chain or transfer to a slower store that would allow you more time in general for afternoon tea...:-)

Anything else for the good of the order?

This is a submitted question/dilemma from a young pharmacist known as "M" -- s/he is requesting that the community help her with some professional advice and recommendations from our little blogosphere community.

-=+=-

As a new pharmacist, I have a dilemna concerning my role/authority in the pharmacy.  Since I'm new to the store, I have a lot to learn from the senior techs as far as managing the pharmacy is concerned.  In essence, they are actually training me to run the pharmacy.  For this reason, I sometimes feel like they take advantage of that, and they do whatever they want.  They often come in late and call off last minute.  One technician doesn't like to 'fill' so I end up filling most of the scripts, verifying, and then ringing it out as well.  She claims she has other stuff to do, which she sometimes does.  I can't complain much because she will do certain tasks and help free my ear from the telephone.  However, I'm just not comfortable with her not listening when I ask for her to help in filling. I'm trying hard to learn much so I don't find myself solely dependent on them (technicians).  So far, I've been nothing but nice to them, and they've yet to call in on my shift.  But I know that day will eventually come... Regardless, this has got to stop. We must be able to depend on them as our patients depend on us.

Please help me by providing me some ideas on how I can approach the situation with both my pharmacy manager, other staff pharmacists, and most importantly, address my concerns gingerly with the technicians without alienating them and subsequently finding myself on the wrong end of a string of sick days! I've also got to consider various friendships (or grudges) between techs and pharmacists, or even techs and techs.

Any advice would be most appreciated! Thanks!

-=+=-

Do you want to submit a guest post or discussion topic [since I don't post nearly enough]? Type it up and email it to me via the contact page. Also, let me know if you want your name/email address shared publicly, what POLL question you would like to accompany it (if any), and anything else you think is important. Guest Posts will be edited for grammar and spelling. I may also add emphasis, clarification, funny links, or other silly stuff [I might remove inappropriate stuff as well]. I will NOT alter the content/message of your post.

Additionally, he had the plastic device jammed into a Aerochamber in reverse -- so if you somehow were able to dispense a dose, it would spray upwards rather than into the chamber.

Now, I can see how one could say that this is merely a failure on the part of the pharmacist to effectively counsel on proper use of the inhaler...and you're probably partially right. In all likelihood, when he picked this up for his child, we BOTH assumed that a grown man would have sense enough to either use an inhaler with aerochamber or read one of the three separate inserts / literature that were purposefully put into the patient's bag. The assumption was proven incorrect. This patient was obviously too intelligent to be bothered with reading those stupid papers that patient's so often vehemently deny and exclaim, "throw all that crap away I've got tons of it at home," only to attempt to jam a square peg in a round hole and break the entire contraption. Wow...just wow...

Finally, this gentleman was mad at ME for not repairing the inhaler OR replacing the inhaler at my cost. I got him an override for an early refill (the TIME spent was my cost...right?). As he left he asked "when the boss was gonna be back." I, of course, don't do well with this comment because it's a slap in the face and passive aggressive. Just tell me what your fucking problem is and assume I have sense enough to come to a reasonable end-game.

Prior to this I took the time to look up the number to GSK for him to call and see a coupon or refund for the product he obviously broke. He was mad about it still, and his only concern was "What if I pay for this one, get it home, and it don't work neither?" -- Well, considering you broke the first one, I'd say the likelihood of you breaking another is rather high considering you still haven't opened up to me trying to show you how to effectively use it...Alas, you have more copies of the literature (illustrated ones this time -- for the kids!). If you don't break this one and it "still don't work" -- it's STILL NOT MY FAULT.

I'm sorry, I don't service inhalers. No pharmacy does. If it doesn't work, it's the manufacturer's fault. If you don't know how to use it -- that's my fault. I've done what I can to help on that front. You're gonna have to be a big boy and make a phone call for the rest -- rather than "gimme gimme gimme gimme..." like usual...

I happened upon this little piece of paper one day while returning from the Cough and Cold aisle. I picked it up as I do all little pieces of trash I walk past each day. I unfolded it to reveal, "The Worker's Plea" as the title and the items above listed.

I found these statements quite intriguing. Since that day, I have done the best I can to implement these ideals into my pharmacy and treat my fellow pharmacists and technicians according to this doctrine. Not long after I found it, I held a pharmacy staff meeting after closing hours (even required those no scheduled to come in -- don't worry, they punched in!). I went through every item on this piece of paper -- along with some notes that jotted in a little notebook in which I taped this sliver of paper.

I told my pharmacists my expectations of them -- allowing the technicians to hear this. I told my technicians my expectations of them -- allowing my pharmacists to hear this. This, I feel was pivotal. I often think that things change after I leave -- that the technicians "get away with more," or that the other staffers don't hold them to the same level of expectation as I do. Now that everyone is clear on their role in the pharmacy, we began to hold each other accountable.

A month or so after this meeting, I spent about 15 minutes talking with each technician and 30 minutes talking to each pharmacist about how I felt they were doing since their expectations were set -- an evaluation of sorts. These meetings were all held during time I was scheduled off -- so my commitment to excellence was displayed. Some were doing exceptional. My pharmacists had become more authoritative over the technician staff and held them accountable for their errors. My technicians took their role more seriously -- as an adjunct to a pharmacist -- a necessary cog in the machine! It was going well. Of course, some technicians still did not take their positions seriously -- they called in sick, wasted time doing various non-imperative tasks to avoid certain difficult or trying duties, or did not try to improve their performance after pharmacist correction (like inputting a script incorrectly). These points were made in the meetings, and change was expected.

Yet, we continued on with the same problems -- Technicians calling in sick, making the same error over and over on similar prescriptions, or wasting time away from the pharmacy. After expectations were set, staff pharmacists being made aware of expectations, and a meeting with me, I was perplexed as to why this stuff was continuing.

I had laid out my expectations of my pharmacists and my technicians. Technicians were given plenty of opportunity to perform their tasks, learn from their mistakes, and better their performance. I had a meeting with every member of the staff to let them know my evaluation of their performance in their job duties -- which I felt were constructive, to the point, pertinent, and not demeaning or intimidating in any way. They had all been properly trained in ever facet of pharmacy from start to finish -- they knew how to do the job right. They knew the seriousness of mistakes -- that lives could sway in the balance. We had retrained and added supplemental help when mistakes continued whether it be knowledge of sig codes (like a list of common ones next to keyboards), or miscounting (by requiring fillers to circle the quantity on the page that prints out), or selecting the wrong drug (by requiring fillers to WRITE the middle four numbers of the NDC on each page as a double check). Still -- the mistakes were happening, and we had been lucky in that I and my fellow pharmacists caught them. What was I doing wrong?

I'm sure by now you all see what was going wrong. Once I looked at the big picture, I saw it. I knew what it was. I couldn't believe that I missed it -- time and time again. I felt bad that I let it get to that point -- I felt like a huge dick.

I was so focused on correcting the mistake with negative feedback, I neglected to reward the correctly filled prescription with positive feedback. To me, it's much simpler. Knowing that the right medicine got to the right person is the reward. Educating people on their prescriptions is the reward. Hearing the positive feedback from the patient is the reward. Yet, the technicians may not get this feedback firsthand. It may not even be the type of positive feedback they are looking for. This was the problem. The technicians were so worried about the negative feedback (which was far from a 'bitch out'), they were allowing themselves to make silly mistakes over and over again.

You have got to tell your technicians when they do it right -- that you appreciate their accuracy, promptness, positive attitude -- everything. Less mistakes made by technicians means fewer mistakes get by pharmacists. We've got to thank them for being an imperative part of our pharmacy. Now, I let my technicians know they are appreciated by both kind words and actions. I applaud their efforts when they think out a particularly difficult prescription or really use their noggin' to solve a pharmaceutical 'puzzle.'

I've also implemented a few other things. On Friday, lunch is paid for by the pharmacists. Period. It took some coercion to get the other pharmacists on board, but we all split it evenly -- even if we are not working that day. Whatever the technicians decide is what we eat...and we don't skimp. Appetizers, deserts, several courses. Whatever! In the past, technicians called in sick on Friday for a 3-day weekend. Not anymore! Now, I have to keep track of who works Fridays to ensure that each technician gets an equal amount of "Free Food Friday."

I've also started a Blue Jeans Fridays. Not much to brag about here as it's not that innovative, but my technician's can wear blue jeans on Friday at a cost of one dollar. All of this money goes into a coffee can and once it gets up to a sufficient amount, we do something with it. One time we donated $150 to a local baseball team trying to get money to go to a tournament. Another time we had milkshakes from Sonic on a slow Wednesday.

Thank your technicians. Thank your pharmacists. Ensure your pharmacy is a positive work environment. You'll see it increase your level of customer service. You'll hear more positive feedback from your patients. And, best of all, you'll have less mistakes get out the door.

I'm not quite sure if I was meant to find it, just got lucky, or perhaps someone left it just for me -- But I can honestly say I'm very happy to have discovered The Worker's Plea. It has helped me help a few that help thousands.

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.

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...

• 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...

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 a half point. I'm not sure the affect the article had on it, but I'm betting it might have had something to do with it.

Anyway, you know the CEO's had to get the spin out to their pawns in the trenches. Here's what Walgreen's 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 you're infallible, 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 your system. I worked at Walgreens during my first year of pharmacy school -- I quit after one semester because my experience sucked so bad. Upgrades since? Maybe. But, Walmart's technology still 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 and the data cannot be denied. Sometimes, it might be worth it to just suck it up and hire more people. But that'd cut into profits now AND later...wouldn't it?

Point Three? Bogus. 1 Billion dollars? Yeah right. Your profit last year was 15 billion. 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...and what their focus islll

Point four is an act of deferral. Placing the blame on the doctors rather than your substandard staffing and increased workload. See point 3. Also, it should be noted that eRx, to me, has been nothing but a clusterfuck. 1 in 5 eRx's that I receive is incorrect.Whether it's a stupid nurse, or a click-happy doctor, it's just as dangerous and error prone as a scribbled written prescription.