-=+=-

I understand the Unites States requires every pharmacist to get a doctorate prior to becoming qualified. However, in Australia, it isn’t required. It is still an undergraduate degree, so we come out after only four years of studying, do a year’s internship, pass our registration exams and we’re done. Every year, we have to enough “points” every year to remain registered as a way to encourage our ongoing learning.

As I’m still in my third year of my degree at the wonderful University of Sydney, we are required to undertake externships, where we get sent to pharmacies for “workplace experience”. I undertook my externship at a medical centre in Sydney’s north.

As one would presume, the entire purpose of my presence there was to learn. The medical centre pharmacy was small enough for only one pharmacist and pharmacist assistant to run the store.

I was questioning the pharmacist present at the time of the several of the drugs people came in for. One of them was quetiapine- as one should know- an atypical antipsychotic.

“What class of antipsychotic is quetiapine?” I asked.

The pharmacist replied curtly, “I don’t know.”

At that time, the pharmacist assistant, who is also qualified, hospital nurse, commented that he should know coz he just passed his registration exams a few months ago.

So I continued to ask: “Why do antipsychotics cause suicidal thoughts at times?”

“I don’t know.”

 Do you fucking know anything?

Let’s try something else then. “Why do topical corticosteroids thin out the skin?”

“I don’t know.”

How much did you bribe the examiner to let you pass your registration exams?!

Ok, so I dropped that topic. So I asked about shingles. “I heard shingles is called herpes zoster, but it’s caused by the varicella virus. So does that mean herpes and varicella virus are the same?”

Again, “I don’t know.”

The pharmacist did not look at me the entire time, so I looked at the computer screen he was typing away at. He was on Wikipedia searching up shingles.

WIKIPEDIA.

SURELY, THERE ARE MORE RESPECTABLE & TRUSTWORTHY REFERENCES TO TURN TO? ALL OF THEM HAVE AN ELECTRONIC VERSION AVAILABLE. MEDSCAPE. AUSTRALIAN MEDICINES HANDBOOK. MIMS ONLINE. THERAPEUTIC GUIDELINES.

“I don’t know anything. Stop asking me questions.”

That’s exactly what I did. So for the rest of my externship that day, I didn’t ask any questions. This incompetent pharmacist went on to report me with an “attitude, and is not willing to learn”.

Oh wait, what? So did not see that one coming.

I have seen a variety of pharmacists in the professional field over the three years I’ve been studying and working in pharmacies. I’ve seen the best pharmacists who are able to treat palmoplantar  psoriasis and various skin conditions better than doctors can. I’ve also seen the negligent; one pharmacist gave out Nurofen Plus to a patient with an active peptic ulcer just because they requested it by brand.  Even with my incomplete education, I know that I should have offered an alternative, perhaps paracetamol [acetaminophen] for your headache?

The pharmacist I worked with during my externship rivals the worst pharmacists simply due to his knowledge gap. I don’t think customers realise it because all he does is assume the doctor has given all the instructions to the patient, so he doesn’t have to do it, and most customers are regulars so they’ve been on the medications for many years.

Being a young pharmacist isn’t an excuse for being ignorant. Pharmacists are the second most respected profession [second only to emergency workers] so don’t tarnish our reputation!

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...

---------------

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?

---------------

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.]

---------------

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.

---------------

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]

---------------

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....]

---------------

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

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 A.D. - "That potion is merely snake oil, swallow this pill."
1970 A.D. - "That pill is ineffective, take this antibiotic four times a day."
1980 A.D. - "Bacteria aren't the problem. Viruses are enemy number 1! Get this vaccination, but you still better take our pills too!"
1990 A.D. - "Taking pills four times a day? That's ARCHAIC! Take this tablet once-a-day."
1999 A.D. - "That once-a-day tablet is cost prohibitive. Take this cheaper generic. It's the same thing."
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!!!"
2000 A.D. "This XR antibiotic kills all the bacteria in your stomach. Take this bacteria capsule four times a day."
2000 A.D. - "Those vaccines are still working, but our data shows they definitely cause autism and some other nasty shit."
2001 A.D. "No, they don't. The data never showed that. Shit happens."
2003 A.D. - "Bacteria are now resistant to this once-a-day antibiotic. We're probably fucked."
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."

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.

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 [pointing at me as if I were the master of all things Ventolin HFA]...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."

Can you hear a big bellied redneck saying this? HAHAHAHA!

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."

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.

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!

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.

If only he would have removed his head from his ass 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!"

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."

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.

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.

"Well, the other day when you were showing me how to use it, you didn't take that little piece out of there!"
"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."

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.

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...

Here's the Abstract:

-------------------

From: leon <leonce1234@gmail.com>
Subject: too many incompetent foreign graduates
Title: Pharmacist

Message Body:
I am sorry to switch gears on you, but I felt the need to address another issue in the field of pharmacy. As most pharmacists already know, it is very tight job market out there. When I graduated, it was completely the opposite. Sign-on bonuses were common and hourly rates were very negotiable. Most employers were willing to train old and new pharmacists from the very beginning. Fast forward a few years later and all those jobs have practically vanished. Without networking, it is nearly impossible to get your foot into the door.

While I have been fortunate enough to find another job in pharmacy, I noticed a disturbing trend. Generally speaking, I will say most of my classmates were competent pharmacists. They were hardworking and eager to learn and keep up with the latest drug therapies. As I worked in the real world, I noticed some really ignorant and incompetent pharmacists. These pharmacists would not know the difference between Keppra and Keflex (no, I am not kidding). These pharmacists could not tell you the names of other drugs in the same family (ACE inhibitors, ARBs, Cephalosporins, Fluoroquinolones, etc). They could not even tell you the generic name of a drug, much less if there was even a generic on the market. Worse, I started catching their prescription errors on a regular basis and had to explain to customers why our pharmacy was making mistakes. My technicians would tell me, “That floater we had yesterday was dumb as hell. He was asking me questions about drugs.” My other regular pharmacists would shake their heads in disgust after seeing the kinds of mistakes that were being made.

Who are these pharmacists? Foreign graduates. I spent 6 years getting my Doctorate of Pharmacy degree. By contrast, most of these foreign graduates spend only 4 years in school. Unlike most medical schools in foreign countries, pharmacy schools outside the United States are basically looked down upon in their respective countries. Part of the reason is because the education is lacking and does not challenge the prospective student. A pharmacist in China, for example, would make little money and he or she would be working every day to make ends meet. As for a place on the healthcare team, you can forget about it. Pharmacists in other countries are poorly thought of and would not be considered true healthcare professionals. On the other hand, getting into a medical school in China is very difficult. After one enters and graduates from medical school, he or she would still be required to perform a residency in the United States for a minimum of 3 years. Despite all of this, it is apparently pretty easy for a foreign graduate to get a Pharmacy License in just about any state by taking a couple of simple exams such as the Foreign Pharmacy Graduate Equivalency Examination and a Test of Spoken English. Throw in a few hundred dollars and you basically have bought a Pharmacy License.

The biggest consequence in all of this is the rise in prescription errors. I have seen it over and over again at different pharmacies and settings. These pharmacists and pharmacies are a danger to public’s health and safety. Another effect these foreign pharmacists are having is that they are over saturating the job market. I can live with the fact that another pharmacist gets the job I was looking for. There are many competent and very good pharmacists out there in the marketplace. They are mentally very sharp and do their job very well. However, when I see a pharmacist make errors repeatedly, I start thinking to myself, “How can this person not know what they are doing? Where did this person even go to school?” And on most occasions, he or she did not attend a pharmacy school in the United States.

At the end of the day, this country needs to stop just handing out Pharmacy Licenses to anyone who claims to be a pharmacist. A pharmacy education in foreign countries is not equivalent to a pharmacy education in the United States. I am sure there are exceptions to the rule. I am certain there are some highly motivated foreign graduates who proved themselves over and over that they are more than qualified to handle the responsibilities of a pharmacist. I just have yet to see one such pharmacist. In my experience, some schools do a better job of putting capable pharmacists onto the marketplace (UCSF seems to do a good job, in my opinion). Personally, I think all foreign graduates should have to attend pharmacy school in the United States in order to acquire a Pharmacy License (a 3 year or 4 year Pharm.D program). Before someone thinks I am too eco-centric, I was actually born in another country, but I grew up here in America, and English is my primary language. And yes, I am a United States citizen. I just think our profession needs to have a serious discussion on what a pharmacy education in the Unites States is really worth before it is too late.

BEFORE COMMENTING READ THIS:

TheAngriestPharmacist did NOT write this post. He has not commented about the validity, certitude, or accuracy of anything written in the post or in ANY of the comments. Please stop submitting comments accusing TAestP of racism, discrimination, or having anything to do with this post. I only posted this because the author asked to use my site as a place to reach many pharmacists. I will not post accusatory comments about myself. I will delete them and ban the author from the site entirely. If you have an opinion, feel free to post it. Keep the other pointless shit off my site.

California Gurls (the MTM remix)

We all know they suck...but do you know why?

Is it because they are pushing all this clinical pharmacy/residency bullshit down the throat of our schools and therefore our students? Well, yeah.

Is it because they promise to lobby for pharmacy but refuse to accept that retail pharmacy is the backbone of our pharmaceutical (and entire healthcare) system? Well, yeah.

Is it because they have yet to use the power of the pharmacists they represent to achieve the goals they haven't yet set for themselves (because they failed to see the necessity)? Well, yeah!

Is it because they have taken the money of pharmacists across the nation (in the form of dues) and rather than benefit the profession, adequately lobby Congress for ANY change, or fight for pharmacists working 12+ hour shifts without a break (all the while attempting to ignore it's even pharmaceutical care in the first place) they have let the PROFESSION OF PHARMACY become a demeaning JOB? -- Where the community expects it in 5 minutes, for $4 (or free), and to be given a $15 gift card for their trouble? WELL, YEAH!

Is it because they thought it appropriate to waste time and money on THIS STUPID BULLSHIT? Oh, you'd better fucking believe it.

APhA - you had your chance. For fuck's sake, you've been at it since 1852. Now, I will admit, pharmacy has changed for the better. You might have played some role in the changes over the past 20 or so years -- you sure as shit will claim them as your victories. But, for right now, you aren't doing anything.

You've become worthless.

You've allowed yourself to be so focused on expanding on facet of pharmacy, clinical pharmacy (to you "better pharmacy"), you've completely forgotten to take care of the boys in the trenches -- retail pharmacy -- WHERE YOU FUCKING STARTED AT!

Well, now you've been weighed, you've been measured, and you have been found wanting.

There's somebody new in town. The Pharmacy Alliance knows what we want. It also knows how to get there -- utilizing the power of each individual as the source of strength for the whole. You may be the big dog right now, but guess which type of pharmacists make the most money? That's right -- the ones that you have scorned, ignored, and left for dead.

I gave you a little coin in the past. I regret that now -- seeing that you used it to make stupid ass videos and pander to your special BCPS buddies. Instead of give that little to you, I'm giving a lot to TPA (once they get that whole 501c3 thing sorted out of course...:-)

Sincerely,
TheAngriestPharmacist

PS - I realize the irony that I was moonlighting as a clinical pharmacist. My buddy's vacation is over, he's back from Midyear, and that has come to an end. They offered me the job, and I didn't take it. I'm a Retail Pharmacist, bitches.

PPS - I'd like to thank Tom, loyal reader and pharmacy student extraordinaire, for pointing this ATROCITY out to me.

I'm thinking about going to pharmacy school. What are the requirements? Will I get in? I heard it's hard from my friend. Would you do it again?

Well, as everyone knows, that question is a mouthful. Let me address each question in separate sections. What are the requirements? Well, the assumption that I know the requirements of every pharmacy school in the United States is quite humbling. I realize people are just 'thinking out loud' when they ask this. If you really wanna know the requirements for a specific school, find their webpage. It'll be on there. If it's not, call them. They'll tell you -- it's not a secret. I would GUESS that most schools want at least a 26 on the ACT. A 28 is probably a given. IF you have a 30+, you can get into any school you want. I would imagine most schools look more heavily at ACT than GPA these days, but your GPA should at least be in the top 20-25% [Top 10% would be better]. Most schools are also going to want you to have some extra curriculars: Student Council, National Honor Society, Sports, Math/Physics Clubs, Future Business Leaders, etc.

Now, I'm assuming that your applying to a 6-year program, where you are in pharmacy school right after high school. If someone is inquiring about a 8-year track, where you get a 4-year undergrade, apply to pharmacy school, then do 4-year of actual pharmacy school -- that's a completely different ballgame. That's going to be based MOSTLY on your PCAT (Pharmacy College Admission Test) score. I didn't take that, so I don't know how it's scored or what you need to get into pharmacy school. In this route, they are also going to want you to have a much better GPA -- at LEAST Top 10% I'd assume. Organizational involvement is also a plus: Student Government, fraternities, Young Democrats/Republicans, etc.

Will I get in? That question is totally based on the requirements and what each specific institution is looking for. Honestly, being a minority does not hurt in some cases. In my class, I had 4 black females and zero black males. Does that mean my school is racist? No. It means none applied, otherwise they would have been accepted if they met the minimum requirements for admission. Of course, I went to school with a lot of Indian and Chinese students -- so it wasn't all white. [Just throwing that in there]

I heard it's hard, would you do it again? First, I want to direct your attention to the image below. It is a picture of a poll that I ran on my website from March 5, 2008 to June 10, 2008.

As you can see, a whole lot of pharmacists would go again (if 18-years old of course), but a whole lot wouldn't. I, myself, would go to pharmacy school again if I were 18. You aren't wrong, pharmacy school is difficult, but in the long run it is worth it. I came out of pharmacy school with $100k debt, but I make $100k+ per year before taxes. I plan on having that paid off in 15 years from my graduation date.

Pharmacy school is hard, but it was a lot of fun for me. The difficulty of the curriculum makes the atmosphere on Friday night very interesting. People drink for a reason -- to forget the pain of failing that test, quiz, etc. My school was far from a party school, but there were a ton of great times and wild parties. Some people party a little too hard, and they fail out...actually, lots fail out. My class started at ~220, and I graduated with about 150-160 -- I think. Why is it so hard? To weed out the fools. My school always said they didn't weed out students, but that's bullshit. Every school has to do it in graduate level programs to reduce class size, and for the reason I said -- removal of idiocy.

In pharmacy school, however, the students really form a bond. In an environment where the school is fighting against you day-in and day-out, a very overwhelming aura of US versus THEM develops. The class really sticks together -- especially in the latter years. Why? Because there's no reason for competition. The C+ student gets the same Pharm.D. as the A+ student. Now, don't get me wrong, everyone hates transfers for busting the curve, making it harder on everyone, and asking asinine theoretical questions extending class time, but that aside, we stuck together. Because of this 'bond,' I really think the friends you make in pharmacy school mean a little more to you than friends you meet in college that may not even be in the same school of study as you. I met my wife, my two best men, a ton of fraternity brothers, and lifelong friends at pharmacy school. To this day, I have 40-50 numbers in my cell phone of people in my pharmacy school. I may not call them -- we may not have been close friends in pharmacy school. But, I bet if I called them and asked them a question or for a small favor, they'd do it for me. We worked together to get the best of the school -- and not let that motherfucker get the best of us.

So, would I do it again? Yup.
Would everyone do it again? Obviously not.

But, I bet those pharmacists didn't make the most of their school. They spent their nights in their rooms studying...not associating with everyone else and getting the most out of their connections.

-=+=-

Are you sad that you didn't go to Med School? Sometimes, I get this as an added variation. From reading the answer to the above question, it's quite obvious that I'm NOT sad that I didn't go to Medical School. I got accepted into a 6-year medical school program. It would have been year-round, guaranteed mental illness, and very tough. But, I'm sure it offered the same bond-like benefits I spoke of about pharmacy school. Anyway, I don't think I would have enjoyed it. I love my Profession. Sometimes, my job sucks -- but I love pharmacy -- I love drugs -- I love educating people about their drugs, therapies, and general healthcare. Personally, I think I have too much common sense to be a medical doctor. I couldn't imagine making some of the stupid ass fucking mistakes these jokers make on some prescriptions -- like not signing them, writing for blatant obvious interactions (which are the big ones that even someone that only took a semester of pharmacology should know -- Bactrim DS and Coumadin, anyone?), and continually failing to follow simple instructions (Testing Strips -- For Medicare must have diagnosis code and EXACT directions/quantity -- yet I call the same idiot-bastards 2x/wk for this wasting everyone's time). The thought of med school after pharmacy school did cross my mine for 0.0004 seconds. But, it's a round about way to get an MD, and would've added at least 8 more years, 150k more debt, and a ton more headache. Would it have been worth it for another 150k/yr (minimum, of course) and more worries in practice (like crazy malpractice)? I dunno. For some, I guess.

I have a theory though -- your either a doctor or a pharmacist. You can't really be both. You have to know. The personality is different. The profession is different. What you do on a daily basis is completely different. One is diagnosis, the other is treatment. There are a ton of differences. While pharmacy is considered a practice, it is, in my mind, an exact science. Everything in order -- everything in an exact, precise way -- 1, 2, 3, 4, 5. Sometimes, medicine has to be different. Diagnosis may sometimes be 4,2,3,5,1. That just doesn't click with pharmacists. Recipes are a must with pharmacists. Doctors may be a little bit more abstract. Just a random, late-night analysis. Take it for what it is.

How much money do you make? This is another question that sometimes gets tacked on. While that's a very rude question to ask someone, coming from someone looking to spend the next 6 (or 8) years of their life studying to be a pharmacist, it is acceptable in this case. As of writing this, I gross about 110k per year and bring home about 80-85k depending on my donations, income from my other business (not pharmacy related), and some other factors I know nothing about. This is about average for pharmacists, and I work VERY little overtime. It may be lower than what some of you have heard, but I live in a somewhat smaller town and the cost of living is fairly low. Now, keep in mind that when I left college, I had over 100k in student loans. I'm still paying those back, and I will be for another 15+ years. So, again, take it for what it is. We make more, but we are stretched thin until those loans are gone. However, if you live modestly, you can pay them back very quickly. Don't run out and buy a hummer. Wait, save, and spend it later on...:-)

So, does that answer the question? I sure hope so! Any follow up questions or comments?

Further information for those that would ask this question:
Request from 2008 Graduate (2-16-08) - The 2nd most commented post I’ve ever had. My advice for successful inculcation into the trenches for 2008 Pharmacy School grads.
So you are going to Pharmacy School (3-7-08) - Similar to the post for Pharm.D. graduates, but this one is directed to high school grads or those entering pharmacy school.

PCAT Sources:
PCAT practice test
Kaplan PCAT
Barron's PCAT
Peterson's PCAT Success
http://www.pcatprofessor.com/

"I've been reading your blog and you seem to be upset when people treat you no better than a cashier at Walmart. To top it off, you compare what you do for a living (counting pills and dropping them in a bottle) with the work of skilled trades like carpenters, electricians, and plumbers who work on your house.

Let's face it: You work behind a counter in a retail store, you hand things that you didn't build or produce to people and then you take their money. Why would you expect people (customers) to treat you any differently than a Walmart cashier?

Yes, you may have invested $150,000 more in your schooling than the person wearing the Walmart smock but what else separates you? Why should customers treat you like a deity?

By your own admission, you draw a pretty serious salary. I think you should just cash your humongous paychecks and try to give people the service they think they want or deserve. You are not a wise old doctor who is treating a patient. You are simply counting 100 pills (which you did not invent or manufacture) and putting them in a plastic bottle.

I have seen "medication vending machines" in the lobby of hospital emergency departments. I can't wait for the day when these automatic dispensing machines are available in every supermarket. I don't need to talk to someone who went to college for eight years just to get another thirty days worth of a medication I've been taking for years. I want to put my credit card in a machine, press a few buttons and have my prescription drop into a chute.

I get nearly all of my refills via Medco (mail order). I like using my PC to order medication refills in the middle of the night and then seeing the meds in my mailbox in a few days. I don't need someone who is making $150,000/yr to put three Advair 100/50's in an envelope and mail them to me. Some college kid getting $12/hour can do that. I can't stand going to Walgreens and being told "you have to wait for the pharmacist to come over and talk to you before you can leave the store with your new prescription." Why doesn't that rule apply when I purchase meds through Medco?

I'm sorry that customers treat you like dirt. But look at the scene from my side of the counter: You are handing a product over the counter and taking money from the customer. In the customer's mind, you are not very much different than a cashier at Walmart or the college kid working the cash register at a gas station."

Now that he's had his 2 cents (which I wouldn't pay him for), I get mine -- which is worth $55/hr. Advair eh? Who are you going to call when you get a white growth in your mouth that tastes horrendous? I sincerely hope you call the college student. He's going to laugh and ask for a picture to put on Collegehumor. He's not going to tell you that it's a fungal infection, because he didn't go to college and learn that inhaled steroids, like the one in your Advair can do that.

Your Medco scripts are reviewed by a pharmacist. If there are any problems (i.e. drug interactions), I guarantee that you and your doctor will be notified. You aren't "counseled" because a ton of literature is included, and they give a phone number...Legal obligations covered.

Do you have kids? Sick kid at 11pm. Better give the ole' vending machine a call and see what he says to give your 6 month old for a bad cough and high fever. Ask it for the dosing as well...some parents have been killing their kids by OD'ing them on antihistamines. Make sure it double checks the calculations. Or, there's a 24-hr Walgreens around the corner. The pharmacist may be asleep or watching a movie, but if you wake him up or get his attention, he'll be glad to help.

You're right in accessing our knowledge versus carpenters, electricians, mechanics or other trades. They have vast knowledge. I planned on doing a post on this in the future, but I'll address it know. If my car is going ca-chunk ca-chunk, I'm fucked. I know nothing about cars. I'm not super handy around the house. I can change a lightbulb, but I probably wouldn't trust myself to hang a ceiling fan. I've just never had to do that stuff before. Here's the thing though, if those things don't get done -- I won't die. If grandma stops taking her Warfarin because she doesn't know what it's for, she will die. I can tell you how the Warfarin works, why it works, what it treats, and most importantly, what OTHER drugs interact with it and could cause problems -- leading to that death thing I was talking about. Let's see an electrician explain what an INR is to a patient.

I paid a lot for my education. Sure, I do my fair share of 'merely putting pills in bottles that I didn't create or manufacture' -- but here's the real bitch of it, I could have. I could have gone into pharmaceutical research and development. Hell, two guys in my class DID! I am just not methodical enough to do that. You are right though, I didn't make those pills -- but here's the real bitch of it, I could have. I spent numerous classes learning aliquots and compounding. I could've made that cream, punched that capsule, or molded that suppository. It's mass produced cheaper and faster than I can do it. Many years ago, everything was made by the pharmacist, much like I could do it now. I just don't make every single product to save my patients money.

Scott, you may not think you need a pharmacist. You may not want the help of the pharmacist. That's fucking fine. We don't want you. As the international representative for all pharmacists, I hereby ban you from ever speaking to a pharmacist for any reason. You cannot ask questions. You cannot ask directions. You cannot ask for a tissue when you have a runny nose. You're officially blacklisted, cunt. To be honest, I'd rather spend my time and effort helping those that want to help themselves and respect my educated opinion.

Next time, if I want your opinion -- I'll head over to the Dairy Queen and see which is better: Chocolate or Strawberry.