Finally, A Hot Pharmacist’s Contest We Can Respect

Posted by The *Angriest* Pharmacist as --Not Pharmacy--, Facebook, GUEST CONTRIBUTOR, PHARMACY SECRETS!, Pharmacy School, Sexy Time, Technicians, True Story, store

I’m sure there are hot pharmacists out there. Why do I work with the ugmos and or dudes?

Prove to me there are pretty female pharmacists out there. I’m gonna steal a page from the now defunct hot pharmacists website out there. I’m gonna run a HOT RPH contest. I will filter through the photos and ween down to the top 5 to 10 females them run a POLL on my website to declare the hottest pharmacists. Categories are as follows:

- American RPh Female
- Abroad RPh Female
- Student Pharmacist Female
- Technician Female
- Technician Male
- Student Pharmacist Male
- RPh Male (American and Abroad)
- Cutest Pharmacist Offspring/Spawn
{My wife will judge the male categories}

Winners will get a free ANGRIEST PHARMACIST T-Shirt ( http://www.Zazzle.com/ TheAngriestPharm* ) of their choosing. [Baby's may delegate this to their parents..:-]

Rules:
Cutoff for photo submission will be March 31st. Please email photos to TAestP@TheAngriestPharmacist.com with the category above as the subject line (for easy sorting). To ensure photos are current and of yourself (or spawn), you MUST include a note where you have written “TAestP.com” on a piece of white paper. Please just send your full name, age, and category in the email message (you can forgo your address at this point in case you move before the shirt is shipped or I lose/delete it). I will contact you at *that* email address at the conclusion of the contest for your address if you are selected by myself or my ole lady as the winner.

By transferring the photo to me, you are giving me permission to publish the image, your first name (not last name), and state/country of residence in any medium forever. I will respect the privacy of your name, home/email address, and other private information. I will protect this information to the best of my ability but assume no liability in the event shit goes down outside the realm of my control.

Pharmacist’s licensure will be confirmed through the state board of pharmacy before declaration of winners — in case any of you hot, non-pharmacists are thinking about scoring a free t-shirt.

Already received FOUR legit (albeit webcam) entries via Facebook email. I really would prefer them in my email inbox at taestp@theangriestpharmacist.com as the filtering is set up already and will make judging much easier.

Additional rule — you absolutely positively MUST be 18 to enter this contest. Do NOT send me your photo unless you are 18 or older even if you are in pharmacy school or are a pharmacy technician.

5 Things Your Pharmacist Won’t Tell You About Pharmacy but TheAngriestPharmacist Will!

Posted by The *Angriest* Pharmacist as Courtesy, Education, First Post, Insurance Companies, Laws, Me being a dick, Money, PHARMACY SECRETS!, Patient Education, Pharmacy School, Stupid People, Work Sucks

Recently, there was a huge uproar (caused by me) resulting from a crappy article making pharmacists look like unethical dickwads. Well, I rebutted. You can read PART ONE and PART TWO. The title was “10 Things Your Pharmacist Won’t Tell You.” — I’m about to tell it.

1. “While FOUR DOLLAR PRESCRIPTIONS are good for you, I am usually losing my ass.”
- Sure, the cost is low enough that I make a profit on the medicine, but in the grand scheme of things, I am getting bent over here. We are failing to realize the actual cost of filling a prescription here. I have to pay for: the tech to type it, the computer system that interprets it and runs a DUR/interaction check, the electricity to run it all, the A/C to keep the store cool (and gas for heat in the winter) and staff happy, the water in the bathroom, the cost of having all these drugs in stocks (gotta have it to sell it — my inventory is 100-200k), the tech to count it, the amber bottle it goes in, the label that goes on the bottle, the pharmacist that checks it for validity, the pharmacist that calls to check the dose or confirm something, the bag the Rx goes in, the tech that staples the bag, the staple/r, the tech that rings it out, and the cost of everything else in between. If pharmacies had to sell every prescription for $3.50 profit, there would be no pharmacy.
- To try and make it better, I convert all my people to 3 months for $10. They save two dollars and I can actually come closer to making a profit since there it only 1 dispensing (1 bottle, 1 label, 1 count, 1 check, 1 sale, etc.).
- Wal-Mart invented this program not to help people save money, not to live by their motto, “Save Money, Live Better,” and not to proudly announce, “Watch out for the falling prices.” Wal-Mart invented the 4-dollar prescription program to put independent pharmacies and smaller chains out of business or to at least squeeze them to the brink of collapse. Wal-Mart can sell prescriptions for 4-dollars because when you go in there, you spend hundreds. Who cares if the pharmacy barely breaks even — it got you in the store, right? I realize this falls right in line with how our society operates. Capitalism prevails, and to the victor goes the spoils. Good, great, grand! But, do not question me if I don’t charge you 4 dollars if you don’t make a point to ask for the special and your insurance charges you 5 or 8. Also, don’t expect to get the red carpet when you bring in a stack of 10 prescriptions, all listed on the 4-dollar list, and tell me you’re going to wait on them.
- Finally, you can still expect me to bill your insurance, if you are lucky enough to have it. Your copayment may be 8 dollars, but I will eat that 4 dollars, charge you $4, and smile because your insurance company paid me $10. I actually may make a profit. Don’t hate the player, hate the game. I’m not sure if it’s legal — I’m not sure if it’s illegal. All I know is I can easily do it in my computer system, and it’s the right thing for my business. To the victor goes the spoils, right?

2. “It costs me between 5 and 25 cents to submit your claim to your insurance.”
- So what, right? I get charge that “transmission fee” whether the claim is paid, rejected, or completely erroneous. Therefore, don’t expect a big smile when you hand me a stack of your past 10 insurance cards and tell me, “It’s one ‘uh deez.”
- I submit the claim and it rejects. It sends back a rejection error and code, but it usually doesn’t make a lick of sense. Do I continue to submit it with different ID numbers/group numbers, or is this card just from 1998? Now you see the dilemma. How can I help you if you won’t help yourself. Throw your old cards away — they do you no good. Do you keep expired credit cards so you can show people how you once paid for groceries? Makes a lot of damn sense doesn’t it.

3. “If you have gotten a significant number of prescriptions filled, it’s highly likely you have taken a pill that fell on the ground.”
- Ewwww. Gross. My pharmacist would never do that? Pshh! Some of these tablets are 10 and 15 dollars each. You can bet your ass I’m gonna use it if it hits the ground. I sure as heck can’t charge you, the patient, nor do *I* want to eat that cost, so, I do the only sensible thing and put the tablet either in your bottle or back in the stock bottle to be dispensed to a random person. Don’t worry, I do have some level of concern here — I don’t use it if I’ve stepped on it or don’t immediately pick it up. I find pills everywhere, and I have a huge bottle labelled, “Unknown NDC – Do NOT dispense,” for them to go in to. I draw the line somewhere!
- I have heard stories of some pharmacists out there actually gluing tablets back together when broken to save money. For instance, Levaquin 750mg is more than $20 a tablet and comes 20 to a bottle. If it breaks, I’m going to do all I can to either convince someone to take it, or glue that bitch back together.
- What doesn’t kill you will only make you stronger. Remember, there is no level of sterility required nor guaranteed in a retail pharmacy. [And USP 797 has absolutely no teeth or power of law so :-p]

4. “You may get shorted on a drug even if I have enough to fill your entire prescription.”
- If I have 60 tablets of DrugA, why should you get all 60? Why can’t I ration them out? This is especially true if we are entering a weekend, and I won’t be getting another order in for several days and the drug is one that likely will be prescribed more over the weekend.
- Granted, it is my fault for not ordering more earlier, but this could be do to a brevy of things: a HUGE order just came in — like someone got 500 of them for some reason, the inventory quantity got off somehow, or, gee, the distributor I buy from did the same thing and shorted me a bottle so they could send a bottle ANOTHER pharmacy and spread the wealth around.

5. “Your friends are stupid.”
- If I had a nickle for every time someone took a friend’s advice over my own, I would open my own pharmacy to eventually be put out of business by the corporate machine. I spent a lot of money to get a good education. I studied pretty hard to graduate. I took a big test so the state would give me a piece of paper certifying my intelligence. I let a company pay me a lot of money to stand behind a counter and BE RIGHT — ALL OF THE TIME. That’s right, some people are paid to drive a forklift. Some people are paid to lay bricks. Others are paid to mow lawns. I, however, am paid to be right….and I am good at it. If you ask me a question, and I don’t know that the answer I’m going to give is 100% right, I’m going to go look up the answer. I don’t guess.
- Here’s the normal scenario. Rebecca calls Jenny and asks Jenny how she lost all that weight last summer. Jenny says, “Well, girl, lemme tell you. I went up to Wal-marts and got me some of dem Detox-a-Trim 2 Pills. You take one with each meal, and you can eat whateva you wants! The weight just be fallin’ off yo’ fat ass.” — Rebecca knows Jenny lost weight, so those must be some good muthafuckaz. So, she comes to me and asks me, “Are these good?” while holding a bottle of Detox-a-Trim 2 which sells for $35.99 per 60 capsules. I tell Rebecca, “No ma’am. None of those really work. They are mostly caffeine or herbal stuff that turns in to caffeine. There may be some vitamins or minerals in there, but those don’t help you lose weight. Honestly and truly, the best way to lose weight is to follow a few simple steps: cut out sodas by switching to water, decrease your portion size or leave a little bit left on your plate every meal, be sure to eat 3 square meals a day — you don’t lose weight by skipping meals (that makes your body store more!), try and scale back on the sweets, and exercise for 30 minutes a day most days of the week. I know it’s a major lifestyle change to do it all at once, so maybe try and incorporate one thing at a time until you’ve got them all done.”
- That is certainly NOT what your homegirl, Jenny told you, and you know Jenny lost the weight. Therefore, I must be wrong. How else can you explain the weight lost? She said all she did was take the pills now this rich, white muthafucka up in herre tellin’ you bout some,”eat three meals a day, exercise, and stop drankin’ soda…shiiiiiiit….Ima take deez pills and we see…” — What Jenny failed to tell you was that she did all those things AND TOOK THE PILLS or maybe she took the pills AND started using Meth or she took the pills AND had a baby. Who knows? I’ll tell you one thing though, dramatic weight lose does not come from pills alone — period. Anyone that says it does is wrong.
- So, why did you ask the pharmacist? You just wanted confirmation of what you were going to do either way. If I would have said, “Ohh yeah girl, those are the best on the market. We should put them in the water supply, and we’d all be skinny little white bitches,” you would have been tickled pink. But, I burst your bubble with knowledge, common sense, and suggestions of an alternative, but you didn’t care. Too bad so sad, thanks for the $36 dollahz YO!

-

This is the beginning of a series of posts.

Things Your Pharmacist Won’t Tell You About Pharmacy (but TheAngriestPharmacist Will!) — PART ONE!

7 to 10 of the 10+ Things Your Pharmacist Won’t Tell You

Posted by The *Angriest* Pharmacist as Disgusting, Drug Companies, Education, Insurance Companies, Laws, Me being a dick, Me hating others, Patient Education, Pharmacy School, Stupid People, TPA, True Story, Update, Welfare, Work Sucks

The first part of this post containing number 1 to 6 can be found at: http://www.theangriestpharmacist.com/2009/05/12/1-to-6-of-10-things-your-pharmacist-wont-tell-you/

Let’s get back to ripping this bitch up… [The Article was originally published in "Smartmoney Magazine" on April 28th, 2009. No primary author was identified -- that was smart...otherwise I would be CALLING him/her.]

Update: Their main source for information is a man named Larry Sasich of Pennsylvania. I visited the PA Board of Pharmacy and he is NOT a registered pharmacist in the state of PA. Way to verify your sources there Smartmoney.com — BTW, I’m sure he’s a nice man and very smart. You can’t be an idiot and make it to his position at what seems to be a very innovative, accredited  pharmacy program/school. I’m merely calling in to question every single fucking what that came out of his mouth. It’s all junk, bogus, and bullocks.

Update 2: His bio on the schools website says Larry D. Sasich, Pharm.D., M.P.H., F.A.S.H.P. — also says he’s a nuclear pharmacist and the creator of that trainwreck of a site called Worst Pills, Best Pills (WorstPills.org). DrugMonkey has a link to it — it’s how I first found it. Most of it is trash, but it opened my eyes on how they found this guy for the article. Scaring people into questioing everything and being insanely/overly cynical is right up this guy’s alley.

Update 3: I have posted a comment on the article at SmartMoney.com — You can view the comment HERE. I also sent an email to Dr. Larry Sasich who is a main contributor to items 7 through 10. You can view the email I sent him HERE.

-=+=-

7. “Paying out-of-pocket? The price of your prescription just went up.”
- I love how this article completely ignores the way businesses operate in every other sector — assuming that the business aspect of pharmacy should run differently than say, the grocery business. Does a gallon of milk cost the same at the gas station ($5.95) as it does Schnucks ($4.15), Walgreens ($4.60) or Walmart ($3.95)? [Prices made up but the point remains]. Of course NOT! It’s all based on the contract your business can garner with the milkman, the amount you sell, what portion of your business milk sales account for, et cetera, et cetera, et cetera! Why should pharmacy be different?
- Larry Sasich (Chair of Pharmacy Practice Dept at LECOM School of Pcy in Erie, PA — Year round 5 yr Pharm.D. program) seems to think “The pharmacist has to figure out his break even point.” The article also says, “Among the variables is the % of rxs filled covered by insurance. If there are lots of covered patients, the BEP (break even point) is shifted heavily to pts paying full price….generally the elderly on Medicare or the working poor….” — And again Sasich chimes in with his inane babble, “pharmacists can’t push around a big HMO, but they can push arounnd a little old lady.”
- I’m not sure what pharmacies Larry has worked at in the past, but pharmacists do not concern themselves with break even points (I doubt indy pharmacists even do — Angry, care to share?). The ratio of covered customers to cash paying customers also has little to do with how we go about charging patients. I don’t even know what my ratio is! I know that I’m a Medicaid Majority with Medicare not too far behind. Considering only primary coverage I’d guess I’m 40% Medicaid, 35% Medicare,  20% Insurance, and 5% Cash/Self Pay. This is just a WILD guess, and I know it’s off because that 5% self pay seems way too low, but the numbers aren’t working out, I’m tired, and I’ve drank about 4 beers — just enough to feel a baseline buzz and start to get sleepy.
- Next take a glance at the bolded text. This essentially says that pharmacies prey on the elderly on medicare and the poor (I’m assuming uninsured.) This is completely retarded because those over the age of 65 now have access to Medicare Part D. Even those that are poor can qualify for SOMETHING to cover their medicines. Those below 150% of the poverty level (or whatever the exact number is) as defined by MY state qualify for Medicaid. So really, the groups he’s saying pay the cost that pharmaciSTS recoup after poor  reimbursement from insurance payors DON’T REALLY EXIST due to our socialized systems set up to protect those very groups.
- Finally, we end the section by saying pharmacists can’t push around big HMO, but they can push around granny grunt. I’m offended by this statement. Firstly, I don’t need to push around HMOs or insurance companies. I have my corporate counterpart to deal with those dickheads. And, for what it’s worth, there’s no such thing as pushing around HMOs. The run the show, and not even Walgreens has the balls to stand up to them. Sure, they could drop them, but they won’t A pharmacist personally has no business dealing with HMOs in most circumastances. So, that is a pointless statement. What offends me is this dickwad insinuating that pharmacists, since they cannot wheel and deal with HMOs take out their frustration on innocent elderly women. That’s asinine. And, once again, they have Part D to cover them as well as Medicaid.

8. “This medication is stale.”
- This has an example of a crooked pharmacist diverting short dated drugs from a nursing home distributor in NINETEEN NINETY-ONE — that’s right, 17 years ago! He bought them cheap and dispensed them and some of them were out dated in some instances. It also talks about buying quantities of meds that are “far bigger than they’re legally allowed to handle.” I wasn’t aware that there was limitations on how much you could carry. I understand limits on compounding as a percentage of your total sales — as well as the likelyhood that there are limits on the number of CIIs you can order or have on the shelf….but I don’t know what the article is referring to.
- Anyway, this bullshit point is just another example of fear mongering. Believe me, the likelyhood of a person getting a short dated drug or expired medication is getting less and less each day. I know it’s hard to catch, but I always try and check the date on drugs that I don’t dispense often as I am checking them. I also put red stickers on drugs that expire within the next 3 or 6 months just as a way to ENSURE I check the bottle each time.
- And like many chains do, I return drugs that expire within the next 100 days. Picked that tip up from Wally world.
- I wouldn’t say this to a patient, but from what I’ve been told and picked up along the way, medication expiration dates are usually just a guess. They really have no idea, but the FDA requires them to have an expiration date…so they stick on on there. I, personally, will take most medications that are way expired (I dunno, a year maybe?) unless of course smell funny or have aspirin in them. [Aspirin DOES expire - sometimes before it's date Acetylsalicylic Acid breaks down into ACETIC ACID (Vinegar) and Salicylic Acid (Wart Remover)] — I love my in-laws to death. My father-in-law and I are very good friends. I wish we lived closer because I enjoy him so much, but they are PACK RATS! I’ve found meds in their closet that expired when I was still in high school. I had a headache, and their 800mg Ibuprofen was filled in July of 1997…worked fine. Don’t say placebo effect…:-)

9. “I don’t just sell drugs. I make them.”
- More fear mongering. If the mass produced product is available, you are going to get it in 99.9% of pharmacies out there. While many pharmacists may ENJOY compounding and are completely qualified to do so, I doubt ANY of them would ignore the stock bottle on the shelf so they can brush up on their aliquots and punch 30 capsules or break out the mortar and pestle to crush tablets for a suspension. It’s irresponsible, not profitable (contrary to what this article says), and TIME CONSUMING.
- Again, I’m not sure where Larry Sasich got his pharmacy experience, but I think he’s done nothing but talk out of his ASS. If he had an RETAIL pharmacy experience, he would KNOW that NO insurance company is going to pay for a compounded drug when the same thing is available commercially. He’d also know that when you take into account the time taken to compound something, you actually lose money while considering the big picture.
Example: I made an Omeprazole Suspension the other day. It was 20mg/5ml #150mL. 30-20mg Omeprazole capsules costs what? Less than 5-10 dollars? It also requires 30mL Cherry Syrup, Baking Powder, and distilled water. Total cost of goods? We’ll say 15 dollars. I had to triturate the contents of the capsules. Wash the mortar with cherry. Incorporate the baking soda. Wash again. Shake well and wait some time as it fizzes HORRIBLY, and QS to 150 with water. My total time spent was like 20 minutes (counting my interupptions). So, my reimbursement was fair. I got back the cost of goods sold and something like 13 dollars on her insurance plan. Good deal right? WRONG. As a pharmacist, I make a dollar a minute (I know, life’s a bitch). Since I spent between 15 and 20 minutes doing it, my 12 or 13 dollar profit is GONE as I didn’t make back my own salary. Of course she might have bought a lot of shit, but I doubt it.
- The Ole’ Apothecary and I often exchange emails. He sent me one last night not long after Part 1 of this post went up alerting me to the necessity of Excedrin prior to completion of the smut published by SmartMoney.com — He also produced a very good point concerning compounding. In the “olden days” Pharmacist was *THE* healthcare worker. There were no doctors. There were no manufacturers. Compounding was the LIFEBLOOD of pharmacy. That is precisely why the mortar and pestle are still the logo of pharmacy. That is precisely why pharmacy students are still trained thoroughly in what is all but a dying art. It’s cheaper to mass produce. There’s also less chance of error and CONTAMINATION.
-Contamination brints me to my next point. The example they use in this section is “some pharmacists compound drugs that already exist such as INJECTABLE MORPHINE or HRT…because it’s cheaper…they do that so they can make more money,” says Larry (flying by the seat of my pants) Sasich. Now, think about what’s wrong with this picture? INJECTABLE MORPHINE CANNOT BE COMPOUNDED IN RETAIL PHARMACIES. Why, you ask? Because it would have to be a STERILE product as it is going to be used intravenously. Products for injection are required to be sterile (or delivered from the manufacturer as sterile) due to the potential for injection if contaimnated. Have you every seen a LAMINAR FLOW HOOD IN A RETAIL PHARMACY? I haven’t. I’m sure there are a FEW out there that have them, but certainly not enough to make this statemtn not seem retarded,

10. “You can get any prescription you like online.”
-Yep, you can also pay hundreds of dollars for Pez. There are a few legitimate websites out there, and if they are legit, I’m not 100% opposed to them in CERTAIN circumstances. The circumstance? The patient is taking the medication LONG term, on a stable dose, and completely versed in the medication being delievered to them.
-But, before someone does this, I want them to ask themselves this: What do you pay for at a pharmacy? You pay for the drug, granted. But, a lot of the cost is for ME — you pay for me! And what happense? You don’t get the drug on time, or something gets CFed and you come crawling back!
- Here’s what scares me about the situation (aside from the lack of direct pharmacist intervention or counseling or people getting grifted by shady pharmacies) – people getting adulterated medications that did not come out of an FDA inspected pharmacy. Drugs that came from Canada or Mexico — an area of the world that cannot even sanitize its own drinking water for safe human consumption. Awesome….

There you have it folks — my take on the TEN THINGS YOUR PHARMACIST WON’T TELL YOU

I am going to come up with a REAL list tomorrow to share with the world. A legitimate list of things your pharmacist won’t tell you along with the explanation. Something that people can ACTUALLY benefit from without trying to scare the shit out of them.

Certified Techs have big heads?

Posted by The *Angriest* Pharmacist as Blogs I like, Courtesy, Education, Laws, Management, Me being a dick, Me hating others, Pharmacy School, Stupid People, Technicians, True Story, Work Sucks

POLL FUNCTION REPAIRED!
E-mail me with poll ideas/suggestions.

Recently, there was an intriguing comment posted to the classic post titled, THE WORKER’S PLEA. Take a second to read that post and its comments.

Fast forward to now. The following comment was left by pseudonym, “Floormat Boss.” Let’s help him out with some constructive comments, direction, and help.

I also buy lunch for tech, praise her, and treat her as human . This has worked fine UNTIL she  got certified. After this she thinks she is a pharmacist. I constantly tell her not to counsel patients, to which I get but I know, more on this later. I get “told” ring up Mrs. Smith, Other RPh, (who is pharmacy manager) expects it done like this.  She has known Mrs. Jones for years and she can counsel her because of this and they had a section about it on the test! She basically acts as though I am her equal and we both work for pharmacy manager. When I explain this is not the case it is my license, I get flippant remark about we are all trying to reduce errors, or some other rot.  I have worked in store for 7 months and she and pharmacy manager have several years. The situation did not rear its head until a month ago when the princess became a certified tech, with my help I seem to have created a monster. I have been in the business as a kid growing up in a pharmacy, as an intern, RPh and even several years as a district manager. I am not an inexperienced kid, and I have not seen this behavior previously. I wonder if it is new to the industry now that certification is becoming more universal? I know what to do and will soon have a long talk with the young lady, which will no doubt end in tears and threats to tell either the pharmacy manager, if he is not included in the talk, or the district manager, if he is included, or human resources dept. if all 3 of us are there. I would appreciate any input from anyone else if they experienced this new behavior from our newly certificated “colleagues” it may help me to keep my sanity or at least from murdering a previously likable and skillful pharmacy technician.

I can understand how someone would allow this to give them a big swollen ego/head. I know many pharmacists that, fresh out of college, passed a test and immediately became the flying spaghetti monster’s gift to pharmacy. The thing is, they didn’t know shit. Yeah, they knew about drugs — what their school taught them. They knew big things, but they didn’t know a damn thing about operating a pharmacy, dealing with the public, and working as a pharmacist. Their swollen head, however, made things bad because they consistently guessed or ASSumed what the answer was to the issue — and they were routinely wrong.

I know in my post, The Worker’s Plea, I talk about how there is more than correcting wrong answers to get maximum tech satisfaction (which is directly related to pharmacist satisfaction). It takes positive reinforcement as well as negative and neutral.

In this situation, it sounds like negative reinforcement is necessary to bring this egomaniacal bitch down to size. Point out every single mistake in every facet of her job. She won’t quit. If she thinks about it, she won’t quit without bitching to every level of management first — so you’ll know when to dethrottle.

After each correction you have to hammer the point home, “That was something I learned in pharmacy school,” or “It’s okay. I don’t expect you to know things like that because you are a pharmacist,” or even my personal favorite, “Don’t worry. This decision is out of your pay grade, anyway.”

Cold-hearted? Yes.
Completely rude? Absolutely.
Super Ultra Dick Mode? You betcha.
Absolutely unnecessary? NOPE!

I realize that I handle situations different than most everyone that visits this site, and we are all successful in our own ways. I just choose sandpaper over charmin on occasion.

The original commenter, I’m sure, would enjoy many more ideas — so throw your ideas and thoughts out there.