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	<title>The *Angriest* Pharmacist &#187; Patient Education</title>
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		<title>Two months worth of reader email</title>
		<link>http://www.theangriestpharmacist.com/2011/12/02/two-months-worth-of-reader-email/</link>
		<comments>http://www.theangriestpharmacist.com/2011/12/02/two-months-worth-of-reader-email/#comments</comments>
		<pubDate>Fri, 02 Dec 2011 09:12:48 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=1022</guid>
		<description><![CDATA[Sorry, I've been....deficient the last two months. I'm not going to promise any more, but I can tell you this. I will have a response for Mr. Plagakis pretty soon. Don't expect anything revolutionary. Don't expect anything mindblowing. Just expect a clear, concise response. Naught but the truth. I also want to look back at [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/12/02/two-months-worth-of-reader-email/' addthis:title='Two months worth of reader email '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>Sorry, I've been....deficient the last two months. I'm not going to promise any more, but I can tell you this. I will have a <a title="A Closely Guarded Secret" href="http://www.jimplagakis.com/?p=4817" target="_blank">response for Mr. Plagakis pretty soon</a>. Don't expect anything revolutionary. Don't expect anything mindblowing. Just expect a clear, concise response. Naught but the truth. I also want to look back at some older posts in which he referenced me about <a title="Jay Pee is just Bull Shit STEAM RELEASE" href="http://www.jimplagakis.com/?p=2470" target="_blank">releasing steam</a> (in a hilarious masturbation simile) and how/why the post titled, "<a title="Jay Pee catches Wal-Mart peeping through the window" href="http://www.jimplagakis.com/?p=158" target="_blank">Jay Pee catches Wal-Mart peeping through the window</a>" relates directly to all of it...</p>
<p>Below, I'm going to post several different things that came to me via email or the<a title="CONTACT" href="http://www.theangriestpharmacist.com/contact/" target="_blank"> CONTACT link</a>. 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...</p>
<p>---------------</p>
<p><strong>Liz writes:</strong>    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?</p>
<p>---------------</p>
<p><strong>Rodney writes:</strong>   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.</p>
<p>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.</p>
<p>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.</p>
<p>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)?</p>
<p>Any thoughts? Similar experiences?</p>
<p><strong><span style="color: #ffa800;">[TAestP's thoughts: </span></strong><span style="color: #ffa800;">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.</span><strong><span style="color: #ffa800;">]</span></strong></p>
<p>---------------</p>
<p><strong>Lillian writes:</strong>     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?</p>
<p>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.</p>
<p>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?</p>
<p>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.</p>
<p>---------------</p>
<p><strong>Kristin Writes:</strong><br />
Dear TAestP,<br />
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.</p>
<p>TAestP, what would you recommend doing?</p>
<p><span style="color: #ffa800;"><strong>[TAestP's thoughts: </strong>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<strong>]</strong></span></p>
<p>---------------</p>
<p><strong>Mike writes:   </strong>so...i witnessed a patient ingest 90mg of methadone...the patient's prescribed dose was 40mg...i gave him the wrong bottle</p>
<p>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?</p>
<p>&nbsp;</p>
<p><span style="color: #ffa800;"><strong>[TAestP's Thoughts: </strong>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).</span></p>
<p><span style="color: #ffa800;">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....<strong>]</strong></span></p>
<p>---------------</p>
<p>That'll do for now....check back for the next post coming soon....</p>
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		<item>
		<title>Random Musings Concerning The Last Week&#8217;s Pharmacy Meanderings</title>
		<link>http://www.theangriestpharmacist.com/2011/09/30/random-musings-concerning-the-last-weeks-pharmacy-meanderings/</link>
		<comments>http://www.theangriestpharmacist.com/2011/09/30/random-musings-concerning-the-last-weeks-pharmacy-meanderings/#comments</comments>
		<pubDate>Fri, 30 Sep 2011 06:07:35 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Courtesy]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=1017</guid>
		<description><![CDATA[1. Monday, I had a lady come up to the counter and ask where I carried the "Lacklend, Lacklyn, or Lacklin -- something like that." [I asked her for some possible spellings] After searching, I was pretty sure she was looking for Lac-Hydrin...possibly Lansinoh which is Lanolin. I presented these findings to her along with [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/09/30/random-musings-concerning-the-last-weeks-pharmacy-meanderings/' addthis:title='Random Musings Concerning The Last Week&#8217;s Pharmacy Meanderings '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>1. Monday, I had a lady come up to the counter and ask where I carried the "Lacklend, Lacklyn, or Lacklin -- something like that." [I asked her for some possible spellings] After searching, I was pretty sure she was looking for Lac-Hydrin...possibly Lansinoh which is Lanolin. I presented these findings to her along with a product list of the various sizes of Lac-Hydrins. At this point, she became adamant that it was "LackLend" and that I wasn't looking right. At this point, I told her I thought I remembered them having the product on sale at a specialty pharmacy that is about 45 minutes away. Since she didn't bother to call me, I can only hope she drives all the way there to get the product. Either listen to reason or get told complete bullshit.</p>
<p>2. Had a very rotund person (never seen her before -- so not a regular) came in and ask me about getting a shingles vaccine as she did not want to catch it from any of her friends. I told her that it was in no way contagious. She goes on to say that 2 or 3 of her friends have it or have had it and that her doctor told her that "IT. WAS. CONTAGIOUS!" I told her that "I will back off my previous statement a very small bit -- If a person comes into contact with a shingles rash, for instance if they are covering the wounds and come into contact with the actual seeping wound, they could potentially catch CHICKENPOX if they had not previously had CHICKENPOX or the CHICKENPOX Vaccination. Shingles, meaning the form of chickenpox that comes back up later in life and causes serious pain, cannot be transmitted from on person to another." [Source: http://www.immunize.org/askexperts/experts_zos.asp] Her response was a steadfast, "Well, my doctor doesn't agree. He says you can get it from anyone that has shingles on their skin or has ever had it."</p>
<p>At this point, I once again took the position of not giving a fuck. Either listen to reason or go away. I told her, "If your doctor is telling you this, and he is serious, I think you need to get a new doctor. As I can print out several different papers and references in just a few minutes that would disprove that notion."</p>
<p>Her response was, nothing less than I expected, "Maybe I should get a new pharmacist..." I just sad, in a trailing voice but loud enough for her to full figure out what I PROBABLY said, "I think you should do that you stupid fat bitch..."     Believe me...she was being a standoffish, stupid, fat bitch.</p>
<p>3. Had a lady come to pick up a refill for, of course, Xanax. It was later in the night -- slowed down immensely. I was completely caught up and actually listening to the radio a bit. She came to the pickup window, I looked up her name and immediately saw that we had requested refills, and we had not heard back. She looks me right in the eye and says, "Is it in you box? I mean...can you check your box?...Is it in your box?"    I really wanted to say, "Why no, have you checked YOUR BOX? I'm sure we could hide a set of car keys in there!"  Instead, she goes into a long diatribe about how a 3 months ago she came to pick up her refill and we told her it wasn't called it...only to find out that after she drove "all the way to the doctor's office," [a gas-chugging 4-5 minutes away] "it was sitting on the counter as there was a problem with it." [The doctor faxed it back sans signature] So, I stand by the statement that the doctor hadn't really done his job! At that juncture, we had faxed them back for ANOTHER Auth. Today, I told her that our inBOX didn't receive prescriptions (just email). She asked me to check our voicemail BOX, and I told her I didn't need to as our number of VMs is displayed on screen [I had ZERO]. No other BOXes to check...cept yours, biggun'!</p>
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		<item>
		<title>The History of Medicine</title>
		<link>http://www.theangriestpharmacist.com/2011/07/22/the-history-of-medicine/</link>
		<comments>http://www.theangriestpharmacist.com/2011/07/22/the-history-of-medicine/#comments</comments>
		<pubDate>Sat, 23 Jul 2011 05:46:34 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Doctors]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/2011/07/22/the-history-of-medicine/</guid>
		<description><![CDATA[THE HISTORY OF MEDICINE 2000 B.C. - "Here, eat this root." 1000 B.C. - "That root is heathen, say this prayer." 20 A.D. - "That prayer is good, but you have to pray in my name me to get through to Dad." 1850 A.D. - "That prayer is a superstitious chant, drink this potion." 1940 [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/07/22/the-history-of-medicine/' addthis:title='The History of Medicine '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>THE HISTORY OF MEDICINE</p>
<p>2000 B.C. - "Here, eat this root."<br />
1000 B.C. - "That root is heathen, say this prayer."<br />
20 A.D. - "That prayer is good, but you have to pray in my name me to get through to Dad."<br />
1850 A.D. - "That prayer is a superstitious chant, drink this potion."<br />
1940 A.D. - "That potion is merely snake oil, swallow this pill."<br />
1970 A.D. - "That pill is ineffective, take this antibiotic four times a day."<br />
1980 A.D. - "Bacteria aren't the problem. Viruses are enemy number 1! Get this vaccination, but you still better take our pills too!"<br />
1990 A.D. - "Taking pills four times a day? That's ARCHAIC! Take this tablet once-a-day."<br />
1999 A.D. - "That once-a-day tablet is cost prohibitive. Take this cheaper generic. It's the same thing."<br />
1999 A.D. - "Their generic once-a-day tablet isn't good enough anymore. Our 'XR' tablet is now the standard of care. And you only have to take it once-a-day!!!"<br />
2000 A.D. "This XR antibiotic kills all the bacteria in your stomach. Take this bacteria capsule four times a day."<br />
2000 A.D. - "Those vaccines are still working, but our data shows they definitely cause autism and some other nasty shit."<br />
2001 A.D. "No, they don't. The data never showed that. Shit happens."<br />
2003 A.D. - "Bacteria are now resistant to this once-a-day antibiotic. We're probably fucked."<br />
2011 A.D. - "Oh yeah, we have immune systems. That's why the vaccines work. Let's just drink the damn tap water and shut the fuck up."</p>
<p>Note: I amused myself writing this. I know the dates aren't even close to right, but it's all so true. Feel free to fill in the holes and make corrections via the comments. Let's tweak this, finish it up, then send it around the Internet like some of the other stupid bullshit I get.</p>
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		<title>Voicemail prescription on Memorial Day</title>
		<link>http://www.theangriestpharmacist.com/2011/05/30/voicemail-prescription-on-memorial-day/</link>
		<comments>http://www.theangriestpharmacist.com/2011/05/30/voicemail-prescription-on-memorial-day/#comments</comments>
		<pubDate>Tue, 31 May 2011 04:43:38 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Courtesy]]></category>
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		<category><![CDATA[antibiotic]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=968</guid>
		<description><![CDATA[Had a doctor call in a prescription today...on Memorial Day. I could tell from his tone on the voicemail he left that HE WAS PISSED. He was bothered. He was angry. He was leaving a prescription for, let's call him Cal Ripkin. Here is the message verbatim: "Prescription for Cal Ripkin. Zpak. No Refills. This [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/05/30/voicemail-prescription-on-memorial-day/' addthis:title='Voicemail prescription on Memorial Day '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>Had a doctor call in a prescription today...on Memorial Day. I could tell from his tone on the voicemail he left that HE WAS PISSED. He was bothered. He was angry. He was leaving a prescription for, let's call him Cal Ripkin. Here is the message verbatim:</p>
<p>"Prescription for Cal Ripkin. Zpak. No Refills. This is Dr. Johnson."</p>
<p>Luckily, I knew who Dr. Johnson was because he did not say his first name. I could just hear it in his voice that Mr. Ripkin called him at home or through the exchange acting as if he would absolutely die without a ZPAK STAT! And, rather than tell Mr. Ripkin to stop being a pussy and take a nap and some Tylenol, he just called in the prescription. Is antibiotic begging becoming some sort of weird variation of drug seeking?</p>
<p>Mr. Ripkin called me moments later and arrived mere minutes later. He needed that fucking ZPAK...</p>
<p>As I'm ringing him out, he doesn't ask about cough medicine. He doesn't ask about Advil or Tylenol. He doesn't ask me any REAL questions at all. He does hold out his hand and show me his palm. He's got a giant blister -- looks like it was from fighting a push mower without gloves.</p>
<p>"Will this ZPAK help with this blister?"</p>
<p>"I don't think it will. It's not super-red. It's definitely not infected. I wouldn't have torn it open -- maybe you could cover it with some super glue or Nu-skin to keep it from hurting."</p>
<p>"Oh. I kinda thought.....well....okay...thanks...."</p>
<p>&nbsp;</p>
<p>So, let's recap here. Patient calls doctor for antibiotic. Doctor doesn't ask why, what for, or any questions. (It's for a blister, by the fucking way) Patient doesn't tell doctor what it's for. (It's for a blister, by the fucking way) Pharmacist fills it, patient comes to pick it up and pharmacist discovers patient wanted it for a blister, BY THE FUCKING WAY.</p>
<p>What a waste of time, money, resources, and my patience. This is one of the biggest examples of problems within our healthcare system -- WASTE and MISUSE OF ANTIBIOTICS. Super bug, anyone? This is how we are going to create it....</p>
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		<title>Unfortunately, this is a TRUE story</title>
		<link>http://www.theangriestpharmacist.com/2011/03/17/unfortunately-this-is-a-true-story/</link>
		<comments>http://www.theangriestpharmacist.com/2011/03/17/unfortunately-this-is-a-true-story/#comments</comments>
		<pubDate>Fri, 18 Mar 2011 03:37:20 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Drive-Thru]]></category>
		<category><![CDATA[Education]]></category>
		<category><![CDATA[Insurance Companies]]></category>
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		<category><![CDATA[$4]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=950</guid>
		<description><![CDATA[I swear on the life of my unborn children that the following conversation is almost 100% exactly as it happened. Right as it concluded, I went and recorded a "note" on my iPhone to help me remember this idiocy...<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/03/17/unfortunately-this-is-a-true-story/' addthis:title='Unfortunately, this is a TRUE story '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>I swear on the life of my unborn children that the following conversation is almost 100% exactly as it happened. Right as it concluded, I went and recorded a "note" on my iPhone to help me remember this idiocy...</p>
<p>----------------------------</p>
<p>"I was wondering, if I brought a list of my medicines up here, could you tell me how much each of them would cost?"</p>
<p><strong>"Are you on file here? And do you have insurance?"</strong></p>
<p>"I've never been here before, but I have Paid insurance."</p>
<p><strong>"Well then, unfortunately, I cannot. Your best be would be to look on the back of your card and call the Member Services or Customer Service number listed there. They can tell you exactly how much each prescription will cost. All I can give you here is the cash price which doesn't do you any good when your insurance will foot the bill in most cases."</strong></p>
<p>"I don't understand. Can't you just put it in the computer and see?"   [Gotta love that all-powerful, "computer" that does all and knows all!]</p>
<p><strong>"That's not how it works. If I had valid prescriptions on file for each one, I certainly could just push a button or two and tell you, but you aren't on file here. So, I can't do anything to help you. If you'd rather bring me a stack of prescriptions I can get you prices then..."</strong></p>
<p>"Well. That doesn't make any sense. I've got a list at home with all the prices on it. Why can't you just tell me what they cost? You're a pharmacist!"</p>
<p><strong>"Wait. You have a list of all the medicines, what they cost, and you want ME to tell you what they cost? You want me to tell you what that list already says?"</strong></p>
<p>"Noooo....well, not exactly. You see, at the last pharmacy I went to they gave me special prices on some medicines. Not the expensive ones. They ran those [the expensive ones] on my insurance, but there were some that were cheaper if they didn't use my insurance."</p>
<p><strong>"Are you talking about the '$4 list' generics?"</strong></p>
<p>"Yeah! That's it. How much are those here?</p>
<p><strong>"Well, they are $4...we honor that program. Unfortunately, I don't have them all memorized, but if you bring in what you got, I can figure it all out."</strong></p>
<p>"Well, I've got a list of the ones that are $4 at Wal-Mart at home. Don't you have that list?"</p>
<p><strong>"Wait. You have the list of what your prescriptions cost on your insurance at home. You ALSO  have the list of ALL the $4 prescriptions at home. But, you want to bring me a list of your prescriptions. You want me to look at those two lists that you have at home in your possession and tell you what those lists, <em>that you have in your possession</em>, say. And you want me to compare those two numbers and tell you which is cheaper."</strong></p>
<p>"Exactly. Which is cheaper HERE..."</p>
<p><strong>"Really? ..........[Long Pause of disbelief].......... Sure...bring everything you have to me...I've got nothing better to do. I'll show you how to do one and we'll see if you can get it from there....If not, I'll get you a quote."</strong></p>
<p><strong><br />
</strong></p>
<p><span style="text-decoration: underline;">What he got from our conversation:</span> That nice pharmacist will put my prescriptions in the computer and tell me what they cost if I bring him a list.</p>
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		<title>Scaring a doctor shopper straight before it&#8217;s too late</title>
		<link>http://www.theangriestpharmacist.com/2011/03/11/scaring-a-doctor-shopper-straight-before-its-too-late/</link>
		<comments>http://www.theangriestpharmacist.com/2011/03/11/scaring-a-doctor-shopper-straight-before-its-too-late/#comments</comments>
		<pubDate>Sat, 12 Mar 2011 04:19:23 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Disgusting]]></category>
		<category><![CDATA[Doctor Shopping]]></category>
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		<category><![CDATA[medicaid]]></category>
		<category><![CDATA[Medicaid Fraud]]></category>
		<category><![CDATA[Norco]]></category>
		<category><![CDATA[Pharmacist]]></category>
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		<category><![CDATA[prescription]]></category>
		<category><![CDATA[Scared Straight]]></category>
		<category><![CDATA[Vicodin]]></category>

		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=942</guid>
		<description><![CDATA[Young lady brought in a prescription today for #14 Vicodin. I'm not sure why doctor shoppers haven't figured this out yet, but one of those ignorant comments you make is, "I DON'T WANT THIS RUN ON MY INSURANCE!" That comment immediately raises my suspicion level. Now, this young lady didn't say that -- it was [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/03/11/scaring-a-doctor-shopper-straight-before-its-too-late/' addthis:title='Scaring a doctor shopper straight before it&#8217;s too late '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>Young lady brought in a prescription today for #14 Vicodin. I'm not sure why doctor shoppers haven't figured this out yet, but one of those ignorant comments you make is, "I DON'T WANT THIS RUN ON MY INSURANCE!" That comment immediately raises my suspicion level.</p>
<p>Now, this young lady didn't say that -- it was a variant that can be equally suspicious, "How much does this cost? Cash Price. I no longer have insurance." The fact someone says this isn't always suspicious, but the fact she said it twice (and awkwardly at that) did set off my bullshit detector. She told me that she wasn't on file -- luckily she was -- and lookie there....A MEDICAID CARD! I, of course, didn't tell her that I had this information.</p>
<p>I ran it, and low and behold, it rejects. I call up Medicaid to inquire about doses, quantities and where. They tell me a Norco 7.5/325 #90 (30 day supply) filled at a nearby CVS about 14 days ago. [The Medicaid agent gave me the Fraud Line and urged me to call. She also said that the new Rx could be filled in NINE DAYS based on carryover days, etc.] The Vicodin prescription was written 4 days ago. I called CVS, verified Name, birthday, medicaid ID number, and made sure it was picked up. Now, we have a problem.</p>
<p>I wrote her Medicaid ID number right next to her name (very big). I also wrote a note explaining the entire situation on the face of the full page prescription. When she came back to pick up the prescription, we had the following exchange:</p>
<p>[The most unfortunate thing here is that while the following is occurring, there is a 4 or 5 year old little girl stumbling around in front of the pharmacy munching on a cherry Dum-Dum I had given her...unable to comprehend the gravity of what was going on in front of her...the mistakes her mother was making before her eyes.]</p>
<p><strong>"We have a bit of a problem here. We had you on file, and we happen to have your Medicaid Card and ID number on file. As we ran this it came back that it was a refill too soon and duplicate therapy."</strong><br />
<span style="color: #ff0000;">"I don't have any insurance or medicaid. I didn't fill anything at CVS..."</span><br />
<strong>"Stop lying to me. I called Medicaid and they told me that #90 Norco 7.5/325 tablets were filled at CVS 14 days ago. I called CVS and verified this information. They also checked the signature logs and found your name signed to the electronic pad. Now, if you genuinely have no idea how this prescription got filled or what is going on here, I can pursue this matter further. However, if you are lying to me, of which I have ZERO reason to believe you are telling the truth, this will end very badly for you."</strong><br />
<span style="color: #ff0000;">"No Sir. That won't be necessary."</span><br />
<strong>"I was told by Medicaid that you can fill that in 9 days. I wrote that date on the prescription along with a little note in case you decided to try and take it anywhere else. I've also notified the area hospitals, clinics, and pharmacies through our area 'doctor shopping fax tree.' I also have no choice but to call the Medicaid Fraud Line and notify them of this. I hope these measures prevent you from making any more attempts to acquire controlled medications. Up to this point, you haven't been caught. In the future, you will get caught, and what you are doing is a felony, and it's fraud. Now, for your young daughter's sake, I would hope you turn over a new leaf."</strong><br />
<span style="color: #ff0000;">"I will. I promise. You don't have to worry about me ever again. You don't have to call anyone about me. I'm sorry. Thank you. Have a nice day...."</span> [And she scampered off as quickly as possible with her daughter in tow.]</p>
<p>&nbsp;</p>
<p>For what it's worth, I did not call any hospitals, doctors, or clinics, and we don't have a "doctor shopping fax tree" (but now that I invented the idea of it, it sounds like a great idea!). I also have no yet called the Medicaid Fraud Line because I was on hold for more than an hour (I left it on speaker), so I gave up and hung up. I said all that stuff in an attempt to scare a 23 year old girl back onto the straight and narrow path. Maybe it was too harsh. Maybe I was wrong in doing all of that. What do YOU think?</p>
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		<item>
		<title>No fix needed &#8212; you&#8217;re an IDIOT</title>
		<link>http://www.theangriestpharmacist.com/2011/03/10/no-fix-needed-youre-an-idiot/</link>
		<comments>http://www.theangriestpharmacist.com/2011/03/10/no-fix-needed-youre-an-idiot/#comments</comments>
		<pubDate>Fri, 11 Mar 2011 05:29:45 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Courtesy]]></category>
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		<category><![CDATA[Proventil]]></category>
		<category><![CDATA[Ventolin]]></category>

		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=937</guid>
		<description><![CDATA[Some of you may remember the post from a few days ago where a guy asked me to fix his inhaler / aerochamber. Well, tonight I finally filled in all the holes. He came back in...as angry as every. I asked him what the problem was and his exact response was precious: "I asked you [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/03/10/no-fix-needed-youre-an-idiot/' addthis:title='No fix needed &#8212; you&#8217;re an IDIOT '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>Some of you may remember the post from a few days ago where a guy asked me to <a title="Does ANYone fix inhalers?" href="http://www.theangriestpharmacist.com/2011/03/06/does-anyone-fix-inhalers/" target="_blank">fix his inhaler / aerochamber</a>. Well, tonight I finally filled in all the holes.</p>
<p>He came back in...as angry as every. I asked him what the problem was and his exact response was precious: "I asked you what I'd need to do if I get this inhaler home and it didn't work and you SWORE UP AND DOWN IT WOULD. Well guess what -- the motherfucker don't work. Ya'll are selling defective shit in here, and I've done spent like $80 bucks on these sumbitches and you, yeah, you...right here [<em>pointing at me as if I were the master of all things Ventolin HFA</em>]...are gonna give me my money back....plus some, find out whose got one of these Gaht DAMN things that work, and transfer this prescription there."</p>
<p>Can you hear a big bellied redneck saying this? HAHAHAHA!</p>
<p>He brought all this stuff with him so I said, "Okay...calm down just a second. Pull out the inhaler you got the other day, and let's take a look."</p>
<p>He pulled it out and I nearly laughed because the answer was INSTANTLY OBVIOUS to me what this guy had done. He handed me the Ventolin HFA inhaler. It was in fine shape. I even squirted it in the air to check. I saw the medicine come straight out in burst of air.</p>
<p>Then, he handed me the Aerochamber. It still had the little plastic piece in it from a Proventil HFA inhaler that they had used once upon a time!</p>
<p>He was either removing the canister from the Ventolin HFA, inserting it into the Proventil HFA inhaler (sans canister), and trying to use the mismatched pair which was obviously unsuccessful [and EXACTLY how he broke the 1st Ventolin HFA - which he attributed to manufacturing flaws and ME!!!], OR he was spraying the Ventolin HFA IN TO the Proventil "plastic piece" and bitching about how the medicine wasn't making it into the chamber.</p>
<p>If only he would have removed <strong>his head from his ass</strong> and the stupid little Proventil HFA shell from the Aerochamber, he might have wondered, "I wonder what goes in this little inhaler-shaped hole on this Aerochamber." And then, combined that statement with the thought, "I just BETCHA this masked end of the Aerochamber, that's shaped like a nose and mouth covering, goes over the nose and mouth!"</p>
<p>So, I removed the yellow Proventil HFA 'shell' and held it up and said, "this is trash." I flipped the cap off 0f the Ventolin HFA and inserted it into the chamber. I held it up to my mouth, depressed the cannister, and low and behold, the chamber filled with a life-saving aerosol. To hammer the point home, I held the mouth piece near my face and feigned a big breath as if to say, "This is how you inhale the medicine."</p>
<p>Now, ignorance and common sense aside, this is obviously an example where I thought I had counseled a parent sufficiently, but I failed to account for the aforementioned confounders (ignorance and lack of common sense).  I mentioned this in the last post -- he showed up and I thought THEN, I didn't explain well enough how to use it. Him coming back a second time, just shows ignorance...plain and simple.</p>
<p>When he calmed down and realized that he now knew how to operate an inhaler, something that I had mastered at the age of 4 years old as I was strickened with childhood asthma, he didn't apologize for his swear-laden rant. He merely tried to shift blame onto me.</p>
<p>"Well, the other day when you were showing me how to use it, you didn't take that little piece out of there!"<br />
"That's because I just thought you had the rest of that yellow inhaler at home. I didn't realize that was from something different. See how this Ventolin HFA has a metallic canister and plastic shell. That yellow shell is a Proventil HFA that, once-upon-a-time had a metallic canister with medicine in it as well. I just thought you would've assumed it fit into this chamber much like the other. I had no idea my not removing it would lead you to believe it were a part of this chamber itself. I'm sorry for the miscommunication."</p>
<p>Then...he did the thing that pissed me off more than anything so far -- more than pointing at me like a child, more than cursing at me, more than calling me an idiot to my face. He just walked away. He gathered his things and walked away.</p>
<p>Now, in this whole debacle, I wasn't all that rude, testy, or unkind/unthankful. I was just average...if anything I was a touch condescending. But, I would contend that if he weren't smart enough to grasp the use of an inhaler and chamber, he could not recognize the presense of condescension. But just to up and walk away? To just turn your back without a thank you, fuck you, or hell, even a thanks for nothing, that's just bogus. With all due respect, you fat bastard, eat shit and die old man...</p>
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		<item>
		<title>Does ANYone fix inhalers?</title>
		<link>http://www.theangriestpharmacist.com/2011/03/06/does-anyone-fix-inhalers/</link>
		<comments>http://www.theangriestpharmacist.com/2011/03/06/does-anyone-fix-inhalers/#comments</comments>
		<pubDate>Sun, 06 Mar 2011 07:48:58 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Drug Companies]]></category>
		<category><![CDATA[Education]]></category>
		<category><![CDATA[Insurance Companies]]></category>
		<category><![CDATA[Just a question]]></category>
		<category><![CDATA[Lazy People]]></category>
		<category><![CDATA[Management]]></category>
		<category><![CDATA[Me being a dick]]></category>
		<category><![CDATA[Me hating others]]></category>
		<category><![CDATA[Money]]></category>
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		<category><![CDATA[True Story]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=926</guid>
		<description><![CDATA[I had a guy come in today with a broken Ventolin HFA. He had OBVIOUSLY broken it. As you know, you can remove the cannister from the plastic delivery device. At the bottom of this cannister is a little white piece of plastic. When this piece is pressed, the aerosol is given an exit from [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/03/06/does-anyone-fix-inhalers/' addthis:title='Does ANYone fix inhalers? '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>I had a guy come in today with a broken Ventolin HFA. He had OBVIOUSLY broken it. As you know, you can remove the cannister from the plastic delivery device. At the bottom of this cannister is a little white piece of plastic. When this piece is pressed, the aerosol is given an exit from the cannister. Usually, this is directed out of the plasic device. Well, this old man had broken the white piece off, somehow, to where it cannot be pressed in at all. Obviously, this is my fault.</p>
<p>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.</p>
<p>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...</p>
<p>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.</p>
<p>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.</p>
<p>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...</p>
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		<title>We are the side &#8216;The Profession&#8217; wishes to shun&#8230;</title>
		<link>http://www.theangriestpharmacist.com/2011/02/27/we-are-the-side-the-profession-wishes-to-shun/</link>
		<comments>http://www.theangriestpharmacist.com/2011/02/27/we-are-the-side-the-profession-wishes-to-shun/#comments</comments>
		<pubDate>Mon, 28 Feb 2011 05:21:03 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[APhA]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=921</guid>
		<description><![CDATA[TAestP Angriest Pharmacist:    @theangrypharm We may be referenced in a article without being contacted for FAIR rebuttal!   http://www.ncbi.nlm.nih.gov/pubmed/21098377 TAestP Angriest Pharmacist:    Website references the vitriol spilled from both TAP and I as your 'leaders'... http://bit.ly/eAIDwr Here's the Abstract: Use of blogs by pharmacists. Clauson KA, Ekins J, Goncz CE. College of Pharmacy, Nova Southeastern [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/02/27/we-are-the-side-the-profession-wishes-to-shun/' addthis:title='We are the side &#8216;The Profession&#8217; wishes to shun&#8230; '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
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<p><a title="Angriest Pharmacist" href="http://twitter.com/#%21/TAestP">TAestP</a> Angriest Pharmacist:    @<a rel="nofollow" href="http://twitter.com/theangrypharm">theangrypharm</a> We may be referenced in a article  without being contacted for FAIR rebuttal!   <a rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/21098377" target="_blank">http://www.ncbi.nlm.nih.gov/pubmed/21098377</a></p>
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<p><a title="Angriest Pharmacist" href="http://twitter.com/#%21/TAestP">TAestP</a> Angriest Pharmacist:    Website references the vitriol spilled  from both TAP and I as your 'leaders'... <a rel="nofollow" href="http://bit.ly/eAIDwr" target="_blank">http://bit.ly/eAIDwr</a></p>
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<h2>Here's the Abstract:</h2>
<div>
<h1>Use of blogs by pharmacists.</h1>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Clauson%20KA%22%5BAuthor%5D">Clauson  KA</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ekins%20J%22%5BAuthor%5D">Ekins  J</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22Goncz%20CE%22%5BAuthor%5D">Goncz  CE</a>.</p>
<p>College of Pharmacy, Nova Southeastern  University, Fort Lauderdale, FL 33328, USA. clauson@nova.edu</p>
<div>
<h3>Abstract</h3>
<p>PURPOSE: The characteristics of  pharmacist blogs were examined.</p>
<p>METHODS: Internet search  engines, blog aggregators, and blog rolls were used to identify  pharmacist blogs. Six categories were developed to evaluate blogs,  including practice-based topics, identifying information, positive  language, critical language, professionalism, and miscellaneous. The  most recent five posts on each pharmacist blog were reviewed.  Descriptive statistics were used to characterize the results.</p>
<p>RESULTS: A total of 117 blogs  were identified, 44 of which were designated as pharmacist blogs. No  blogs contained patient-identifying information. Anonymity was  maintained by 68.2% of bloggers. Bloggers practiced in community (43.1%)  and noncommunity (43.1%) settings. Pharmacists most commonly used  positive language to describe the profession (32%), other health care  professionals (25%), and patients (25%). The highest rates of critical  language were found in descriptions of patients (57%) and other health  care professionals (44%). Almost half of pharmacist blogs contained  explicit or unprofessional language. Overall, community practitioner  blogs were substantially more likely than noncommunity practitioner  blogs to use unprofessional and critical language. Twenty-five percent  of pharmacist bloggers also maintained a microblog (e.g., Twitter)  account.</p>
<p>CONCLUSION: A  search using Internet search engines, blog aggregators, and blog rolls  identified 117 blogs, 44 of which met the study criteria for designation  as pharmacist blogs. The majority of pharmacist blogs included some  type of discussion of pharmacologic therapies. Pharmacists most commonly  used positive language to describe the profession, other health care  professionals, and patients. The highest rates of critical language were  found in descriptions of patients and other health care professionals.</p>
</div>
<p>PMID: 21098377 [PubMed - in process]</p>
<p>--------------------------</p>
<p>I really would like the full text of this article if at all possible (meaning if a current student emails it to me I'd love them forever)....I really would like to see what they studied, who they studied, and their goals. I'd also like to see if they mentioned the upcoming @AngryPharmcast --- that'll blow their minds out of the water....</p>
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		<title>Requirements versus Services</title>
		<link>http://www.theangriestpharmacist.com/2011/01/08/requirements-versus-services/</link>
		<comments>http://www.theangriestpharmacist.com/2011/01/08/requirements-versus-services/#comments</comments>
		<pubDate>Sat, 08 Jan 2011 06:15:50 +0000</pubDate>
		<dc:creator>TheAngriestPharmacist</dc:creator>
				<category><![CDATA[Courtesy]]></category>
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		<category><![CDATA[drug interations]]></category>
		<category><![CDATA[drug utilization review]]></category>
		<category><![CDATA[easy open lid]]></category>
		<category><![CDATA[final verification]]></category>
		<category><![CDATA[flavor rx]]></category>
		<category><![CDATA[flavorrx]]></category>
		<category><![CDATA[flavorx]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Interactions]]></category>
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		<category><![CDATA[Pharmacist]]></category>
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		<category><![CDATA[prescription]]></category>
		<category><![CDATA[prescription requirements]]></category>
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		<guid isPermaLink="false">http://www.theangriestpharmacist.com/?p=899</guid>
		<description><![CDATA[The smart alecks that post wise guy comments on my, and other pharmacist websites, usually only have one or two things they say regarding the worth of pharmacists. The root of their hatred for the profession that does so much for the common citizen is seeded in their jealousy of the wages paid to such [...]<div class="addthis_toolbox addthis_default_style " addthis:url='http://www.theangriestpharmacist.com/2011/01/08/requirements-versus-services/' addthis:title='Requirements versus Services '  ><a class="addthis_button_facebook_like" fb:like:layout="button_count"></a><a class="addthis_button_tweet"></a><a class="addthis_counter addthis_pill_style"></a></div>]]></description>
			<content:encoded><![CDATA[<p>The smart alecks that post wise guy comments on my, and other pharmacist websites, usually only have one or two things they say regarding the worth of pharmacists. The root of their hatred for the profession that does so much for the common citizen is seeded in their jealousy of the wages paid to such highly trained professionals. Along the same lines, they only see pieces of paper (money and prescriptions) coming in and bottles filled with 30 pills each going out. Haters see it as overly simplified. Exoterically, from the outside looking in, it is, but for those of us that spent 6 to 8 years getting a doctorate, we don't agree. Compared to backbreaking labor outside in the hot sun, I can at least understand.</p>
<p>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.</p>
<h1><span style="color: #ffa800;">Requirements:</span></h1>
<p>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 <strong>Rx</strong> symbol on the face of the prescription).<br />
2. I input in the computer (the computer system is not required. I could use a typewriter or even hand write the labels).<br />
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:<br />
4. A label is generated and placed on an amber bottle.<br />
5. The appropriate drug is counted and placed into the bottle.<br />
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).<br />
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.</p>
<h1><span style="color: #ffa800;">Services:</span></h1>
<p>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.<br />
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.<br />
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.<br />
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!)<br />
5. Paging your name overhead when your prescription is ready -- that's all southern hospitality, buddy!<br />
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.<br />
7. Flavoring your child's antibiotic with out FlavorRx system.<br />
8. Anything or everything related to having a drive-thru or providing services through it.<br />
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...</p>
<p>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.</p>
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