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Paging Dr Dave… Your douche is ready..

·5217 words·25 mins

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.

Genius? Me? Did you even read the first paragraph of that last entry? You know, the one that I said “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.”
Update: Got the fax yesterday saying that the 10% cuts are here to stay. The injunction was injuncted upon by yet another injunction reversing the injunction-junction (whats your function). Yeah, I cant believe it either. This is really going to suck.

  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.

Yeah, I did put 4 twice. Sorry, my mistake. Thanks for pointing that out to me in the most asshole way possible. I originally had 4 be “all of the above”, but then I decided to add something in about the god-complexes that you oh-so-quaintly have shown everyone still exists.

Unless the PHARMACISTS start lobbying. When they are through WE will
have to pay the State….

Uh, we’re lobbing the hell out of the state. However lobbying does only so much when the state is 1000 trillion dollars is debt.

Here is my own quiz, based on the previous model:
Most, but not all pharmacists are:

  1. Lazy
  2. A dick
  3. Think so little of everyone BUT themselves that they 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 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

Thats cute, just copy and paste what I wrote. I can see now how you got through medical school.
— Round 2 —

I am NOT a chronic pain patient, I am a practicing physician and I am
absolutely sick and tired of idiot pharmacists having a bad day calling
me to tell me what I fucked up on my scripts.

Then don’t fuck up on your scripts 🙂 Seriously, do you think we want to sit there and waste our time calling your obviously unhappy soul to tell you what you messed up on? Do you think it gets us off to be yelled at by some doctor who obviously takes his frustrations out on his office staff and the pharmacist who calls to save his ass? No.

If I wrote a particular
treatment prescription I did it for a reason. Please don’t argue with
me as you attempt to be so many amateur physicians. I realize that you
went to 5 years of school to learn pharmacology, and I respect that.
What I can NOT stand is that fact that none of you seem to respect that
I and my colleagues went to school for 10-12 years and, whether you
want to hear it or admit it, know a fuck of a lot more about medicine
and pharmacology, and more importantly how they interact and will
effect OUR patients than most of the arrogant, self absorbed, insecure
pharmacists that call to tell me I can’t prescribe A with B.

See, the fact of the matter is that if we just “fill the prescription” and the patient dies due to your arrogance and stupidity, then we are at fault just as you are. However if we call and you make our requests known (and obviously document it), then when your arrogance and “10-12 years of school” kills someone (or lands them into the hospital), we don’t get hauled into court. Well, I take that back, we do get hauled into court, and there is no doubt that you would lie and say that you didn’t talk with us about our concerns.
Now due to the condescending asshole tone of this email, I have no doubt in my mind that if we are sitting both in court, the very first thing you would do is point at me and said “THE PHARMACIST SHOULD OF CAUGHT THE MISTAKE” (even though you bitch here that we bug you too much).

Shut up
and fill the fucking scripts unless you are damn sure there is a
mistake. As I get at least two dozen calls a day between “corrective”
calls about my prescribing and suspicions about my patients that I
prescribe anything stronger than Ibuprofen, it gets ridiculous.
Pharm D? THAT is a fucking joke!

Two dozen calls a day? Okay, either this figure is way out of line, or you are prescribing some really shady shit to some shady people. “Just fill the fucking script” doesn’t quite work if the patient received 100 norco from another pharmacy yesterday.
You see Dr Dave, this whole situation really smells fishy. Most pain management clinics really have no problems with pharmacists and pharmacists don’t have a problem with them UNLESS a huge red flag comes up. If “two dozen” pharmacists are calling you about your “prescribing and suspicions” about your patients then obviously you aren’t just giving out Amioderone to a patient on Warfarin (which your *\*10 YEARS OF SCHOOLING!@!@#!@$**** should tell you why that one is a biggie). So tell us Dr Dave, how many gallons of Norco do you write out on a daily basis to have all the pharmacists on alert? Have your Rx’s (and patients) been booted out of every pharmacist in town? Is that why you are so hateful?
You see, part of being a pharmacist is that you get good at sifting through the bullshit.

Comments #

Comment by jean on 2008-07-18 08:50:12 -0700 #

Amen, Brother. Hang that MoFo out to dry. He displays all the signs and symptoms of the guy who is probably Stop #1 on the Doctor Shopping Narc & Pop Map, where “We pay cash so they can’t find us later.” Bet the DEA has him on speed dial.

Comment by countbyfive on 2008-07-18 09:42:24 -0700 #

I take exception to the idea that because physicians go to school for 10-12 years that they know more about pharmacology and medication management. I have yet to meet a physician that knows even remotely what I know (and I’m nothing special) about drugs across the board. Sure, many physicians get to specialize, and you may have me with the handful of meds you deal with regularly, but when I get cardiologists asking me what Relafen is, not how it works, that kind of ruins the theory that all physicians know more about drugs and pharmacology than pharmacists.

Comment by Rebecca on 2008-07-18 10:48:07 -0700 #

after listening to the rants of physicians and reading the rants posted on your website indicating the we are peons who should just do what the doctor says i am tempted to start a lobbying group of my own. if people want us to be pill counters so badly then maybe we should be pill counters. we should stand behind the counters with our spatulas and trays, grinning like idiots, refusing to bill third party payers, and just count by fives. do you want your expensive medicine? you do? then put it on your credit card and i will hand you your medication and a form to fill out and send into your insurance for reimbursement. and if something bad happens? say, like your doctor writes for the wrong medication, or the wrong strength, or the wrong SIG, or for something that interacts wickedly with something you are already taking? oh well. the doctor should have caught it. we pharmacists just count the pills. we clearly don’t have enough schooling to deal with things like medication. let me count…i have a 4 year BS and a 4 year PharmD – so that equals 8 years of school. my husband, a physician, has a 4 year BS and a 4 year MD – so that equals 8 years of school. based on my limited math skills i believe that those are equal. i give you that you endure an intern year, residency, and sometimes even a fellowship – but many of us go to formal schooling for the same number of years.
ahhhh – don’t you miss being able to page someone by name back to the pharmacy? screw HIPAA.

Comment by on 2008-07-18 13:19:07 -0700 #

Here’s what it all comes down to…they, the M.D.’s, went to school for “10-12 years”, while we, the PharmD’s, went to school for 6 years. Why do they hate us? We make the same if not more than they do!! That’s it! Plain and simple. We get to sleep through the night; they get paged over and over again. We see our families; they see divorce attorneys. I’ll take my bullshit PharmD and my $120,000 a year pay that goes with it any day over their lonely, self-absorbed lives. FYI, being a doctor was very distinguishing…20 years ago. Get the fuck over it…your shit stinks!!! One other thing- don’t try to come back at me. I got into two medical schools. I chose to become a pharmacist, and love every minute of it.

Comment by Google Account on 2008-07-18 13:25:28 -0700 #

oh. now i am angry. WE WOULDN’T HAVE TO CALL SO MANY TIMES IF YOU COULD WRITE A FUCKING PRESCRIPTION CORRECTLY YOU DOUCHEBAG. noooo i love to sit for 20 minutes on hold while you masterbate to the QVAR rep talking to you about particle size (anyone else??? i hate that woman). but when you need to call in a diflucan script for your crotch-rot patient and i’m explaining the meds that YOU WROTE to a patient because you shuffled her out of your office in a record 12.5 seconds after giving her albuterol neb solution and no nebulizer, don’t throw a fit because you stay on hold for 10 seconds. i realize that that is the length of a normal office visit from you so each time i make you do that it’s one less patient you see. or something. you know what, thats fine, the next time you write out some scripts for coumadin for your stomach ulcer patient i’ll just wave it away.
oh and it must be nice to think we just took 5 years of pharmacology in school. did you go for 10 years to learn how to write poorly and prescribe inefficient drug regimens for your patients? (hell 5 years of pharmacology would be sweet, no dealing with nasty pharmacokinetics or therapeutics).
i really hope this is not an accurate representation of your profession because i have serious doubt in the survival of all humanity now.

Comment by PHARMACIST Dave on 2008-07-18 14:00:00 -0700 #

WOW, he gets a dozen calls a day about his rx’s…maybe, just maybe it is his crappy script writing..I can’t imagine any doc getting a dozen calls in a week!!! about his prescriptions..this doc must either see 150 patients a day, or just screw up a lot of rx’s
and as far as knowing more pharmacology, well I’d be willing to bet that he knows his 50 drugs that he prescribes, too bad there are thousands more to chose from.
Lets face it, Doc. you were born out of your time..Doc’s arent seen as medical gods anymore..
In my state it is harder to get into pharmacy school than med school..b/c
1} better hours
2} better pay/hour worked
3} not on call (or not as much)
4} demand
so get off the old high horse..

Comment by anonymous intern on 2008-07-18 14:53:40 -0700 #

That doctor is a complete douche. My friend and I are both 4th year pharmacy students, and her sister is an MD. First of all, her sister went to school (undergrad + med school) for 7 years plus a year of residency, NOT 10-12. My point is that she’s no idiot… yet she said that pharmacology was the only thing she and her classmates struggled with.
At my school we have three different levels of pharmacology and dozens of therapeutics classes, so that when we’re licensed, we can catch all the mistakes that Dr. Douche makes. I mean, it doesn’t help when a doctor writes an Rx for Vicodin ES, 1 tab every 4 hours for 5 days(I mean, c’mon, it’s simple math..), or an rx for amiodarone and Crestor for a patient that he also put on Warfarin. So for him to underestimate the knowledge that pharmacists have (and actually use) just makes him look like a piece of shit.
Yesterday, I had a dumbass doctor who wrote a legit script for Percocets, and when the patient told him that Percocets make her feel nauseated, he told her to bring the script to the pharmacy and have the pharmacist call him to change it. WTF? Why not just write a new script on the spot? and why let the patient walk away with the Percocet prescription? Doctors love to waste our time, not vice-versa.

Comment by Tech_grl_in_red on 2008-07-18 15:02:00 -0700 #

i think im in love tap! you give em hell and i’ll keep reading.

Comment by Google Account on 2008-07-18 17:58:08 -0700 #

The scary thing about people like the physician above is that he thinks he really knows pharmacology. This is the time of year when we get our new residents, so we get to see on a daily basis how much pharmacology is taught in med school: it is not very much. There just isn’t enough time in the med school curriculum to cover differentials AND therapeutics. Most med students are pretty awesome, and I always enjoy answering their questions, but the more arrogant pricks I see walk through thinking they learned more in their one semester of pharmacology than I did in my entire PharmD curriculum makes me genuinely fear physicians.
I’m also sick of hearing about Doctors and their “10 years of school.” Doctors go to school for 6 years – 4 undergrad, and 2 med school. Then they’re an intern, which is on the job training, and a resident, which is more on the job training. Note that the BA can be in something like music, or communications. PharmDs have 2 undergrad years minimum (most have a BA), which include the most difficult classes that Premed students go through, and then we spend 3 years in a pharmacy school classroom. We then have rotations, and now we also do (optional) residencies. The programs aren’t much different. Each person learns more about their respective areas. I don’t tell my dentist shit about my mouth, I don’t tell doctors how to diagnose their patients, I don’t tell nurses how to provide patient care, so don’t tell me about drugs. When a pharmacist calls you and starts saying you made the wrong diagnosis, then they’re playing god, but when it’s about drugs, there’s a good chance you should be concerned.

Comment by IAPHRMR on 2008-07-18 18:35:53 -0700 #

He knows a ton more about pharmacology…I DOUBT IT, yes if you are an oncologist you can probably kick my ass across the room about chemo drugs (I hated chemo in college). But give me any other set of drugs and I can wipe you ass across the floor with it. I spent 3 years learning about all different sorts of classes and MOAs (mechanism of action), ADR (Adverse drug reactions)…sorry spelling it out as Dr. Dave might try and get me on my acronyms. What did the doc get a semester? So how could you possibly know more than us.
“Pharm D? THAT is a fucking joke!”
Really, come to my neck of the woods and throw down you Douche! I can get into all the clinical stuff that I am qualified to do and how I work with my local physicians to better my patients to help decrease the number of meds they are on and increase their compliance. I have docs that have people of low doses of 3 or 4 BP (Blood Pressure) meds and we work to put them on higher doses of 1 or 2 meds and they have less pills, higher compliance, and less side effects.
I caught an Rx the other day for an antibiotic of an 11 Kg child that was 4 times what it was supposed to be. Lovely warfarin and Bactrim Rxs being written on the same day by the same doc, that they overlooked. There are lots of really stupid Rxs that I see every day come through my pharmacy. I hear at least once a week “I am really glad you caught that and called me”.
PharmD a joke? If we just put pills in a bottle and did not question things, we would have a lot of hurt people around here. We are the last line of defense when you fuck up. So when we see something that does not look quite right we will call in order to see if you made an oversight on something, i.e. pt has been on Metformin ER for 23 years, yet you send me an rx of Metformin (no ER), or Glyburide instead of Glipizide, Zocor instead of Zestril (seriously had that one 2 weeks ago, not sure why I called to check, but the pt was on an ARB, so that probably caught me off guard).
Plus I have seen some stupid physicians in my time, one in particular had never heard of a study I was talking about in a presentation…Yeah it was not very big, just that Physician’s Health study that brought us the mantra “over 50 should have an aspirin a day”…he had never heard of that…this was in 2005! So I never trust that “you know what you are doing just fill the damn Rx”. If you lived in my area I would be in you office yelling at you you fucking Douche!
Okay…im done

Comment by The Ole’ Apothecary on 2008-07-18 19:09:48 -0700 #

I’ve been through much of the above myself, but the only thing bothers me is the misuse of a name.
The name of our profession—pharmacy.
Many people keep getting that wrong. They utter that we practice pharmacology or go to school for pharmacology or get a pharmacology degree. Well, we do study a considerable amount of pharmacology (the study of the effect of drugs on tissue), but the profession we practice is called pharmacy.
Pharmacy is the knowledge base required to solve drug-related problems. It includes pharmacology, pathophysiology (studying the effect of disease), pharmacokinetics (study of how a drug is absorbed, distributed, metabolized, and excreted), and pharmaceutics (physical aspects of the drug products themselves). It also includes clinical practica regarding all of these disciplines.

Comment by LifeandTimesTech on 2008-07-18 20:16:09 -0700 #

Methinks that “Dr. Dave” actually did go to school for 10-12 years. He’s got the attitude for someone that had to repeat every freaking year of med school cause he copped that attitude with the professors…
Seriously dude, when the techs are catching your mistakes (not just missing signatures, but medication interactions) you’re an idiot.
I actually have a doctor we call 12 times a week. he’s one of the more popular ones, but his handwriting is like Sanskrit….

Comment by Bexx on 2008-07-18 20:53:04 -0700 #

Pharmacists have a HUGE HUGE HUGE responsibility! Not only are their licenses on the line if anyone in their office screws up filling a script, but they have to multitask (even the men) to the extent that a REALLY organized woman would be seriously jealous! You guys rock. My best friend and I read this blog ALL the time and we compare notes. She just finishing med school and I working in a pharmacy and going to pharmacy school. We see both sides, but how unprofessional to LIE about your qualifications like 10 to 12 years.. makes me think SOMEONE failed a few years in there! What are you a neuro-surgeon (Mr. DOCTOR) and why??? Just to attempt to sound like you know your shit. Let’s discuss the dynamics of how this works. The patient calls the pharmacy. The refill script hasn’t been called in to them. The pharmacy contacts the receptionist who gets ahold of the M.A. who leaves a note on your comfy little desk for you to look at right before you head home for the day. Then the patient continues to call the pharmacy CONSTANTLY to see why your ass hasn’t called the refill in to our office. While you are at home eating with your family, we are open till 10pm. Family practice closes at 5 from what I understand. You write one script which is good for 6 months to a year at a time. We process how many hundred per day?!?! EVERY DAY! So shove that up your ass. Besides, in a perfect world, after we administered the Versed to you, you would never know what WE shoved up there! Here’s to PHARMACISTS and their excellent staff everywhere!

Comment by Jen on 2008-07-19 01:02:59 -0700 #

This is REALLY related to the topic at hand, but I was reading some medical journal news and saw that the drug rep’s can’t give any freebies to doc’s after jan, 1st 2009.
i just wondered how you (any of you pharmacists) feel about that?
i think it’s a good thing probably…
also, as i’ve posted on here about my CP and norco etc etc…I begged my Dr. the other day to change my med from Norco to Celebrex as my mother has the same degenerative bone disease that I have and it’s made her quality of life much better so I wanted to try it for a while instead of Norco, he’d never heard of it….
that’s not right is it, it’s also a bad sign no??!!

Comment by Google Account on 2008-07-19 03:53:38 -0700 #

To summarize the long rant going on in my brain:
Dr Douche is living proof that you CAN throw away the baby and raise the cord!… It’s too bad his mother didn’t just swallow!

Comment by James on 2008-07-19 09:51:52 -0700 #

I think I know who this doctor is and if it is him, he is an oncologist who works with experimental therapies. If this is the guy, I can vouch that he might be exaggerating a bit but does get a lot of pharmacist calls a day because of the nature of what he is writing. It is not Norco (to my knowledge it is not too crazy about short half life narcotics) that he is writing – he gets calls because he is writing for new cancer drugs and the questions are always about possible interactions. Also, if this is the Dave I know, then there was an incident recently where a pharmacist completely changed the medications without calling him – that is probably why his post was so pissed off. That pharmacist is not currently actively licensed by California – he was suspended last week – and Dr. Dave (if this is the right one, and it sounds like it) had good reason to be pretty pissed as his patient almost died because of what the pharmacist in question did.
With that said, he did go way overboard with some of what he said.
Thought the Board might like some perspective here.

Comment by nodrugs4u on 2008-07-19 10:49:14 -0700 #

You know, I have nothing better to do than calling MD about their scripts. I made the following 4 calls just yesterday.

  1. Tylenol with codeine. uhh.. Which one? I went to pharmacy school not psychic school. Maybe I will just give whatever I want.
  2. Wellbutrin 150 XR with DAW=1. Great, I’ll just call the manufacturer and tell them to start making XR because Dr. G wants it XR.
  3. Zocor (lovastatin) 40 mg. Thank you for being helpful. I could have filled either one, but you just had to put down both names, thus forcing me to make call you. By the way, Oh Great One, Zocor = simvastatin, and lovastatin = Mevacor.
  4. Septra DS….. allergy: sulfa. This script was a computer generated fax. Unless Septra is no longer a sulfa drug, I have to call.
    This was in just one day. Please, why are the MDs so annoyed when we call you. You think we get off on calling you? Actually, I kind of do. I love that “gotcha” feeling when even the most a-hole MDs have no choice but to admit their mistake.
    disclaimer: 3 out of 4 of those phone calls went smoothly. The MD corrected the script, apologized for the error, thanked me for catching it. This IS the norm. The a-holes are the exceptions and unfortunately they screw it up for the rest of the MDs.

Comment by JustAnotherDoc on 2008-07-20 12:01:46 -0700 #

In the US the vast majority of doctors have a 4 year undergrad degree, followed by 4 years of medical school. Only then does one enter internship for, on average, one year. This is followed by 2-4 additional years of residency.
I agree with a lot of what you guys say, but a few of you should actually look at what it really takes to be a doctor before casting stones. (ie Medical school is not 2 years.) And it goes beyond quantity of years, to quality of those years.

Comment by Smart Person on 2008-07-21 15:43:53 -0700 #

My challenge to Dr. Douche: Fire your nursing and admin staff at your practice. Check in your patients by yourself, triage them by yourself. Administer shots all by yourself. Dispense all your patients’ meds by yourself using all the free samples you get. On your Mondays off, go in to the closest community pharmacy and offer to relieve him/her for the day.
If you want to weasel out of the entire challenge, just do the community pharmacy part mentioned above.

Comment by James on 2008-07-21 19:59:31 -0700 #

I checked and this IS the Dave I thought it was, and there is a LOT more to this story involving the pharmacist in question. Apparently no one can say much since there is now a criminal case against the pharmacist, but suffice to say that, despite the offensive way in which he expressed it, he had an absolute right to be pissed beyond words.
I will post more when I have heard it.

Comment by Google Account on 2008-07-22 13:48:34 -0700 #

You’re my hero.

Comment by rph3664 on 2008-07-22 21:16:10 -0700 #

A physician can, in theory, become a doctor in 8 years, but a lot of them really do have 10 or 12 years of schooling because many of them are in second careers and it’s not unusual for them to have master’s degrees – and M.D./Ph.D takes extra time as well. Those are usually a 6-year program on top of the bachelor’s degree.
There are two doctors in my town who have both an MD and a DDS degree; one practices as an oral surgeon and the other is an ENT. I have even filled prescriptions from physicians who also had a law degree. You wouldn’t want to sue them. lol

Comment by KDUBZ on 2008-07-23 12:20:39 -0700 #

I don’t think anyone here is trying to lessen the education and training of physicians. I would also argue that the quality of both pharmacy and medical programs is pretty intense. I had my share of brutal presentations during rotations which featured me getting raped with questions from 5 or 6 clinical pharmacists for an hour after I had finished. MD’s are experts at diagnosis, pharmacists are experts at drug therapy. Mutual respect and professional courtesy really need to be developed on both sides… should be about the patient after all right?
Also does anyone else here find the posts from James to be a bit suspicious? Is it just Dave trying to justify his previous comments? I mean really, what are the odds that a MD posts here all pissed off and douchey, gets flamed by TAP, and doesn’t respond….but someone who “knows hims” posts saying I know why this guy may have been pissed! In my short time as a pharmacist I have developed a sixth sense for BS…….and I call BS!!!
Evidence A…name a pharmacy that carries experimental chemo therapies!
Evidence B…I really have too much time on my hands, If the Dave is a Cali MD, the story is BS, just check Cali BOP website and the only recent license suspensions come from cases involving diversion and failure to keep proper records.

Comment by Welshpharma on 2008-07-24 05:31:13 -0700 #

I feel sorry for my friends when I hear about GP’s like this, I have only experienced the, “I am the prescriber, i know what the patient needs, just do the script” once myself.
My experience with my GP’s (and i do see them as my gp’s as much as they see me as their pharmacist) is great. they call me all the time asking my opinion on prescriptions, a senior GP partner came into the shop in person to discuss prescribing policy, to make sure it wouldn’t negatively impact on my practice.
The best thing is about my gp’s is that they give me pretty much a free reign, i just send the script back after for changing (obviously not major things that I would need prescibing authority for, but definately more than most of my colleuges get).
I know this is the “angry pharmacist site”, but i like to share my positive experiences in the hope it may make at least 1 person smile about this overworking, undervalued nightmare of a career we all love so much.

Comment by Just A Doc on 2008-09-03 15:12:05 -0700 #

What the hell did this guy originally say?

Comment by Brian on 2008-10-15 12:25:16 -0700 #

Hilarious as can be…my cousin did the 3 year Northeastern Pharm program …he did the chain store trip for awhile …then bought a pharmacy and now works for an HMO. He was a angry guy before he became a pharmacist. But he married a gorgeous nurse.
By the language used it is hard to tell if either the physician or the pharmacist had any education…funny nevertheless.