Why APhA Sucks
APhA - American Pharmacists Association - "Improving medication use. Advancing Patient Care." - Dictators of coveted domain "Pharmacist.com"
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.
The most popular question
I get a lot of questions asked of me via my CONTACT ME page. They range from drug information, to theoretical questions, and even 'online mental statust exams' as I've come to call them. ["I think I'm depressed. What's good for that?"] Of all the questions I get, there's one that I get every other day -- at least.
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/
Proving the Public is Clueless
I got this from Pharmacy Chick. I'm not sure who this motherfucker is that sent this to her, but his name is Scott. I hope he gets a case of malignant hyperthermia and his "medication vending machine" didn't know what he (or his doctor) wanted and instead of spitting out numerous bottles of dantrolene spits out a few aspirin and a cyclobenzaprine.
"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.
So you are going to pharmacy school
I'm sure by now most of you have taken a look at my post on Advice for 2008 Pharmacy School Graduates. Needless to say, the post has been very popular and commented on extensively. It's also been added upon by some others in the Pharmacy Blogosphere, each adding some thoughts based on their career and personal experience. Not long after that gem hit the net, I got a request from PharmerBill, who wanted some advice for high school seniors embarking on Pharmacy School in August. Here we go...round 2!
NOTE: Most pharmacy schools are offering 6-year Pharm.D. degrees, whereas others offer a Pharmacy School program after achieving a 4-year degree and being accepted to the 4-year program. I went for 6 years and will refer to this as such. When I talk about 1st year or 2nd year, it's on a 6 year scale. Others would refer to this differently -- meaning they only consider pharmacy school as four years: P1, P2, P3, P4. So, when I say 'first year,' I mean 18/19 year olds taking basic general education stuff. On my scale, "pharmacy school" doesn't officially start until third year.
Point 1 - First year is a joke.
Point 2 - Since first year is a joke, get drunk, party, and study the night before exams and get pretty decent grades. However, remember, your first year grades do a lot to prop you up throughout the rest of your collegiate tenure. If you start to slip, stop-fucking-partying, and get on the ball. If you don't finish first year with above a 3.0, it's going to be a rough go for you.
Point 3 - Pharmacy School (3rd year and up) is a fucking bitch. Be prepared to fail, but don't fret -- the rest of your class is failing as well. Rack up all the points you can in labs, quizzes, and other stuff, as it will boost your grades as you get D- after D- on the test.
Point 4 - There will be those students that take a 50 question multiple choice test in 14 minutes. You are required to hate them. You must hate them because they are so incredibly smart that they know the answer after reading the first half of the question or because they are so incredibly stupid that they put C for every answer...and that's stupid (unless it boosts the curve -- if you're lucky enough to have a curve in ANY class -- in that case, praise them and get them drunk the night before exams)
Point 5 - Hate those that think, "Does anyone have any questions before we conclude for the day?" means, "Time to ask and asinine question that no one cares about and is only theoretical bullshit." They will be in your class and you will know them by Day 2 of General Chemistry. They will ask questions about weird diseases, stupid fucking theoretical interactions, and stuff they read in the NEJM last week. They suck balls.
Point 6 - If you make it past third year and then drop out for any reason other than severe disease requiring all of your attention, you are a fucking idiot. You've already got 60k+ tied up in an education. How are you going to pay that back in with a degree in accounting? Exactly...
Point 7 - GET YOUR ASS IN A FUCKING PHARMACY. You will encounter some douche bag that is a 5th year and has only seen the inside of a pharmacy on required experiential trips. These people are twits and will find themselves in a world of hurt when they get to their rotations and/or the real world. The things you learn on the job may seem inconsequential, but I couldn't tell you how many times a little bit of experience or familiarity with the drugs saved my ass on an exam. Even knowing the OTC drugs helped in some classes and especially on rotations in community pharmacies.
Point 8 - Do NOT be one of those ass clowns who comes to pharmacy school saying "I'm just going here so I can go to Med School/Law School." That's bullshit. No 18-year old realistically heads to pharmacy school with those high hopes -- they are mommy and daddy inspired and you will see most of them crash and burn faster than a NASA space shuttle (eek - I apologize for that one). Their tune will change as they realize their debt is astronomical and retail money is easier -- especially with that hefty sign on bonus.
Point 9 - Go Greek...It worked for me. I know, deep down, that part of the reason I graduated was because of my Brothers. They helped me - they kept me honest - they provided and outlet for me to vent and gain from. I couldn't have done it without them. I don't care what fraternity you would join. Looking out for the mutual welfare helps -- regardless of the letters (except for Phi Dex, they are dicks -- and everyone knows those fools in KY are gay...just kidding -- relax!)
Point 10 - OLD TESTS ARE GOLD! Gather as much old material you can -- the work is done FOR YOU. Most tests will have 10-15% duplicate questions. Some professors have a limited test question bank and if you have several years worth of tests, you may have access to the vast majority of their questions. Of course, you have to study -- otherwise you might get burned with a new test. Fraternities help here. My chapter had tons of old stuff that we shared amongst each other.
Point 11 - Don't be a dick to your classmates. You will come to realize that you are in it together. What started as 250 will dwindle to 150 by graduation (seriously). Working together will get you a lot farther than being competitive. What do you gain by competing for grades? Not a damn thing. Everyone still gets a degree.
Point 12 - Don't allow the faculty to convince you that clinical pharmacy is the only thing worthy of your degree...that's a load of bullshit, but that's what you'll hear from day one. Drug expert this, therapeutic guideline that, residency this, Board Certified Pharmacotherapy Specialist that...Fuck that - my Pharm.D. is the same as theirs, and I make a tad bit more coin than then. I've got the same training and education as them; I just decided to go another direction. Why they look down on retail? I dunno. If I weren't standing in the trenches, one of them might be...
Point 13 - Live in the dorms or close to campus! Those that live on campus get 15% higher grades than those that don't -- my school once "crunched the numbers." Why? Because they are more involved in their school and their education. If you commute, stay on campus, make friends. They will help when it comes to getting old tests and such. Don't go to class and run home.
Point 14 - I'm not saying give up your friends from "back home," but for Pete's sake, don't live in a fucking suitcase and run back to your hometown every weekend. Homecoming? Sure. Anything else? Meh.
Point 15 - I hate to burst your bubble, but you and your high school girlfriend aren't going to make it. It's a 99.9999% certainty that you will be broken up by New Years. Why? Because there are hundreds (if not thousands) of 18-year old bitches throwing their boobies in your face...and you're going to like it -- and probably open your mouth once or twice (and your fly if you're lucky). Don't screw yourself out of all those fun experiences and random strange because "you're in love" with the same girl you've been dating since freshman year.
Point 16 - If for some reason you do keep a significant other outside of your school or immediate area, DO NOT be one of those stupid motherfuckers that runs out of class at EVERY 5 minute break and jumps on the cell phone. I hated those fucking kids. As soon as the teacher said the word, they were pushing the dial button...it's like they only had that on their mind the last 15 minutes before our break. I hated those kids - and I'll hate you if you turn into one.
Point 17 - Keeping number 15 in mind, don't be a fucking slut. Like I said, pharmacy schoool is about 250 people. You nail 3 girls in a week and it's going to get around. You are going to be avoided by the plague (unless you are the master). Chicks talk more than dudes. You don't want to be labeled a man-whore or slut after a week of drunken fun. Sure, it was a blast - but it will be the only play you get for a long ass time.
Point 18 - Real men marry pharmacists. Can you imagine the possibilities of being married to a pharmacist as well as being one? That 250k gross is a lot of money. You can have awesome cool shit - Xbox 360, PS3, Wii, Nintendo 64, all the works...This also provides a solid fall-back - you fail out, she graduates, you still got a solid income to mooch off of...:-)
Got any to add for our 1st years, Pre-Pharms, and/or P1's? Toss it in a comment!
If you read this far and aren't going to pharmacy school, worry not, some if not all of them will apply to you in some way. Read and learn....
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