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You’re either with us or … a huge douche!

·1887 words·9 mins

As you have read before, California instated a 10% cut for its Medicaid Rx reimbursement.  However, last Saturday the courts overturned the ruling until 8/11/08.  Their computer systems still have the 10% cut, but they will let us know how they wish to deal with that ball of wax once the shit stops falling from the sky in the legal department.

Now, I don’t do this very often so you might want to bookmark/take a picture of this page.  The doctors have done a tremendous job in helping the local pharmacies keep their doors open and their paychecks from bouncing.  They have been more than receptive and more than helpful in switching their patients to generic drugs with little to no prior notice.  For how much shit I talk on doctors on here, they really helped us out.

However (you knew this was coming):

There seems to be a few doctors in town who did not get the memo.  You see, when we fax you a nice little note explaining the cuts and if we can switch our patients to something that cost less (so we wont lose money when we fill what the drug reps sucked you off to prescribe), and you write a big NO on it, that really upsets us.  Its not like you’re a cardiologist or writing for weird stuff like Tekturna.  Denying our request  from Nexium to OTC Prilosec isn’t rocket science, and obviously you must of slept through that class to realize how much power pharmacists have.  In fact, blanket denying everything that we send you to switch with a NO means that you are either:

  1. Lazy
  2. A dick
  3. Think so little of us that you don’t give two shakes of a mouses dick what happens to us.
  4. Have some ill-gotten god-complex that fell out of fad about 20 years ago when managed care/insurance companies snipped off your scroatum and dangled it in front of your face while saying ‘HAW HAW’
  5. All of the above

Like I said before, this isn’t rocket science.  If I would of said that the insurance didn’t cover this medication you would of switched it in a hot second, but because we asked for a professional favor you decide to shit in your hand and rub it in our faces.

However, Pharmacists (believe it or not) like to take the high road.  So when your patient has a stupid medical question like what to take when they are constipated, we will not refer them to you and waste your precious doctor-time.  When potential new patients come and ask what we think of you, we won’t say that you are a flamboyant small-penis douche who hates pharmacists.  We wont make you wait an hour on hold or happen to forget to fax over that med list that one of your dropout front-end girls called and sorta-asked for in something-that-resembled-english.  I’ll look the other way when your minimum wage hired help totally fucks up.  Oh, and when you call me personally for a favor, I will (with a smile on my face), not bring up the time you totally FUCKED us when the cuts happened.  You see, we have professional courtesy, and even though you may bad-mouth us to your patients, we spend 10000x more time with them than you, so they’ll STILL come to us regardless what you say.

To all the doctors who stood up to help small pharmacies stay in business during the cuts, we love you.  We’ll refer patients to you, we’ll sing your praises from when the gates open until the gates close.  We’ll buy you drinks at the CE dinners (heh, they reps buy the drinks, but they dont know that) and run medication by your house late at night when your kids are sick.  We’ll cover for you when you write that Amoxicillin Rx to someone that you knew had a Pencillin allergy but just brain-farted.  We will drop everything to happily look up something that you just as easily could of looked up on your palm-pilot.  We’ll give you our cell phone numbers and open the store at night for those once-a-year emergencies involving a screaming grandchild, zithromax suspension and some auralgan (the original cheap one) drops.

To all the doctors who decided to not answer our pleas for help.  Eat shit.  The cards are down, and we know where you stand.  We will still treat you with respect, but excuse us always looking over our shoulder for the knife when the shit hits the fan.  We are more than just pill counters, and you are damn lucky that (unlike you) we have the moral and ethics to show you exactly how much influence over the patients we have.

Comments #

Comment by Dave on 2008-07-16 22:33:00 -0700 #

Out of your options for refusing to help with the current (non) cutbacks (see, that is what a court order does genius, STOPS something from being implemented, hence NO 10% cut….oh, skip trying to explain THIS to a pharmacist) I must take option 3 below.

  1. Lazy
  2. A dick
  3. Think so little of us that you don’t give two shakes of a mouses dick what happens to us.
  4. Have some ill-gotten god-complex that fell out of fad about 20 years ago when managed care/insurance companies snipped off your scroatum and dangled it in front of your face while saying ‘HAW HAW’
  5. All of the above
    Since most pharmacists I have to deal with here are 1, 2, 4 and (the other) 4 (with THAT counting ability can you wonder why I doubt the competence of most people in your business? 5 comes after 4 genius!). I really think 3 is my own position. Sorry you won’t get a 150% markup on your generics for a while, but in case you didn’t notice, the Feds tried to do the exact same thing to us, and it fell through too. The 10% cut will also die on the vine thanks to the court order.
    Unless the PHARMACISTS start lobbying. When they are through WE will have to pay the State….
    Here is my own quiz, based on the previous model:
    Most, but not all pharmacists are:
  6. Lazy
  7. A dick
  8. Think so little of everyone BUT themselves that they don’t give two shakes of a mouses dick what happens to us.
  9. Have some ill-gotten god-complex that fell out of fad about 20 years ago when managed care/insurance companies snipped off your scrotum and dangled it in front of your face while saying ‘HAW HAW’
    4 (which SHOULD be 5 – leave it to a pharmacist). All of the above

Comment by j- on 2008-07-17 00:01:11 -0700 #

“HAVE,” not “OF” — as in “would have, could have” or “could’ve,” but not “could of.” C’mon. You’re too clever not to know better.

Comment by whylaff on 2008-07-17 08:45:44 -0700 #

Not really about this post, but I am interested in reading your thoughts on this news article:

Comment by Adam on 2008-07-17 10:22:27 -0700 #

if you’re going to wal-mart pharmacy, you deserve whatever you get.
more on point, the grammatical corrections and nit-picky shit is exactly what happens when you hit a nerve. good job, TAP, this was right on point.

Comment by Nate on 2008-07-17 10:52:21 -0700 #

Sounds like Dave is one of those dipshit MD’s that sleeps with the hot Nexium reps. For all of you who don’t understand how Medicaid pharmacy reimbursement works (Dave), here’s a lesson. We electroncally submit a claim for a drug that costs the pharmacy, lets say, $3. They turn around and pay us $3.30. That barely covers the cost of the med not to mention the overhead costs(wages, labels, bottle, TIME, etc.) to dispense it to the patient. See, we get paid nothing for our time to counsel patients on the appropriate use of theirs meds even though it is required by law (thanks OBRA 90). Most docs don’t understand what it takes to dispense a product since all they get paid for is their time and knowledge. If you add a 10% reimbursement cut to an already profitless claim, pharmacy gets royally boned. Then, we might have to start charging for our time. God forbid!! Right? You can’t get someone to come look at your fucking refridgerator for free so why should you be able to just walk in and talk to a DOCTOR of Pharmacy about your health for free? Because we are one of America’s most accessible and trusted professions and most of my patients say we are more helpful than their doctor.

Comment by Google Account on 2008-07-17 13:39:47 -0700 #

Great fucking news, I just received a fax that says some asshole judge reinstated the 10% cut!
I can’t wait to start my new job flipping burgers at In N’ Out

Comment by Drug Dealer in Training on 2008-07-17 16:08:12 -0700 #

Dear Adam-
So you’re saying that every Wal-Mart is at fault and therefore everyone that works there is automatically less of a pharmacist or more capable of making a mistake? You must be right because no other pharmacy in history has EVER made a mistake. It must be nice to know that you are perfect and will never make an error. I understand guilt by association and on general principle I think Wal-Mart is not perfect by any stretch of the imagination, but don’t generalize one error to every Wal-Mart on the planet. If everyone did that, we’d run out of pharmacies in no time at all.

Comment by Crusty RPh on 2008-07-17 19:59:49 -0700 #

I think Dave is one of those that didn’t make it into med school, flunked out of pharmacy school and is now working for a PBM. The poor SOB couldn’t run a neighborhood lemonade stand. Profit is not a dirty word. When we are dealing with trade name drugs that only a have a 5 to 10% margin — you have to have a larger margin on the generics. An average margin of 20% is needed to stay in business. If you actually want to make a profit as an owner you need a 22 to 23% margin or you won’t make anything. Get a fuckin clue Dave. If the asshole will change anything for the Ins Co. what is the problem with changing it for the pharmacy. After 40 fucking years you learn to help each other out or die. These asshole are generally always asshole regardless of the situation. Arrogance gets in the way of common sense. Without each other we are all less than we can be in our professions. Fuck you Dave.

Comment by BIG R.PH on 2008-07-21 14:21:51 -0700 #

You guys in California do it all wrong!
You need to balance your budget for Medicaid like we do in Illinois. We just don’t pay the pharmacies and other providers of Medical Services!!

Comment by EEJ on 2008-07-23 09:31:58 -0700 #

No, not being nit-picky.
For some of us, it hurts our brains when we see people as intelligent and well-written as TAP use terms like “could of” instead of “could have”.
It also makes it hard to read fluidly, as if it were a flashing banner advert or similar.
Please, TAP, start using “could have” or “would have”, or just go the easy route and type “would’ve” & “could’ve”, which is what you appear to mean.