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Most trusted? Since when?

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Everyone has heard that Pharmacists are one of the most “trusted” professions.  Sure nurses yanked that out from under us a number of years ago, but the fact that we are still on the “trusted” scoreboard started to make me wonder what exactly about what we do makes us so “trusted”?

Patients dont trust us.  They yell at us over their copays thinking that we are making a HUGE profit from that measly $50 copay when in fact we are barely breaking even.  They whine and bitch and think we are lying to them when we say that their pain pills are too early.  How many times have we caught a possible serious interaction only to have the patient demand that we fill it anyways because they don’t wish to wait the extra day for us to confer with their doctor (then transfer it out when we refuse)?  How many of us have suggested an OTC product only to have the patient pick the one with the shiny packaging that won’t do a damn thing for them (but Airbone was created by a SCHOOL TEACHER!).  How many times have you told mothers they cannot use a decongestant elixir on their 2 month old baby only to have them grab it after your back is turned?  How many times have we given them medications so they won’t have to sit in the ER only to have all of their Rx’s transferred to a chain for the coupons/gift certificates the very next day?  Someone who is “trusted” doesn’t get yelled at for non-covered drugs or for insurance-company doughnut holes, they should accept what we say (its not like we do this for a living or anything) and go on their way.  How many times have you seen a patient dump all of their pills right there on the counter only to count them (and proceed to dump them on the floor and demand new ones).  How many times has your drug knowledge been called into question because of “my friend said” or “I read on the internet”?  I guess we are trusted enough to know what isle the paper towels are on or to count the blue Lortabs vs the pink ones.

Doctors dont trust us.  95% of them won’t allow us to switch to a covered drug in the same class without going through 10 fax backs that involves their non-medically trained front end staff relaying incorrect messages and completely wrong information.  They dont ever get on the phone to speak to us because they are “too-busy” seeing patients and cant spare the 10 min’s to discuss an interaction that may kill someone (yet they take an hour lunch break every day.  When is the last time YOU got an hour lunch break?)  Yeah, sure they may be “reviewing paperwork” during that hour, but how many times have you gotten mindless “OK’s” when a valid question is written on the refill request in black sharpie?  How many doctors will allow you to use your knowledge over being their human shield/proxy when they piss a patient off?  How many doctors will stand with you against narcotic diversion rather than just rolling over and demand we fill narcs early when the patient starts to whine?  How many times have you gotten a call from a doctor wanting to discuss the narcotic use of a patient and what WE can do to help the patient (I can count the number of times this has happened on one hand, minus a few fingers)  Yeah yeah, doctors are busy, excuse me while I take care of your patient’s issue while I fill the other 1000 Rx’s that your other patients are screaming at me about because they aren’t ready 30 seconds after they call them in.

Insurance companies don’t trust us.  They make us go through mindless audits where they nit-pick /everything/ just so they can yank that drug cost right out of our checks.  We cannot call them for a prior auth even though we have a complete Rx history for the last 10 years AND have doctorates of pharmacy (or 20+ experience in the field) but rather hear some high-school dropout or some community college graduate tell them the exact same information read from a chart.  Our services and education are worth a dispensing fee that is less than the pizza boy who delivers in 30 mins or less.

State Boards/FDA don’t trust us.  They are the first to nail us to the cross and pull our ticket at the slightest word that someone has gone wrong.  They won’t stand up for us against the PBM’s even though THEIR fate is directly tied with ours.  Ever been inspected by the state board?  Ever gotten some minor-ass infraction just because they needed SOMETHING to ding us on to justify their jobs?  “Your fridge is 1 degree above the USP published standard, ignore the fact that I had the door open for the last 5 min’s looking for outdated insulin”.  They make us cram so much information on our Rx labels that it takes a masters degree to sort through all the tiny (and BIG) print to find when a drug was last filled.  We have to hand out STUPID medguides (more on this on another post) that list every side effect known to man that just scare the patient into not taking the drug.  To hell with actually US TELLING them what they need to know!

In fact, the only people who trust pharmacists are other pharmacists SOLELY because we are in the same trench.  Sure patients that you KNOW and have cared for will trust you, but its mostly out of professional friendship gained via feats that you have gone completely out of your way to do for THEM (illegally most likely) vs the inherit trust earned through a pharmacy degree and license.  Oh, don’t piss them off or they will drop you in a hot second for that chain giving out coupons and gift cards.

Not to belittle or devalue the hard work that nurses do, but what do they do that makes them number one in the “trusted” list?  The ones I know follow the doctors orders and care for them while they are in the hospital.  Their “trustworthiness” is not plugging the wrong IV (that has been scanned 100 times through a bar-code system and prepared BY A PHARMACIST) into the IV tube.  They make the patient comfortable and act as proxies to the doctors (the times that I or my family have been hospitalized this is what I’ve seen.  Sure its important, but #1 on the trusted list).  Dont we do the exact same thing?  I mean really, in a hospital setting you’re at the mercy of the nurse since you obviously cant walk around shouting and demanding stuff like they do when they walk into a pharmacy.  Nurses have a little light and call button to summon them, we have a phone and a pissed off patient storming in through the front doors demanding to know why their copays are “so high this month” (when they paid the SAME last month).

Pharmacists are like the kickers of a football team, we either save the day in a pinch or cost the team the game; in both cases we obviously didn’t win/lose fast or cheap enough.  Our shit doesn’t smell better or worse than ANYONE in medicine, yet we’re the human shield.

Oh hell, what do I know.  I just put vicodin and soma in little bottles not fast enough to keep the unwashed masses from bitching and moaning.  Yeah yeah, it’ll be ready in 10, your ride is impatient.

Comments #

Comment by Tim W , Pharm.D. RPh on 2011-01-05 00:47:50 -0800 #

Amen… amen

We fill Enbrel for a certain patient every month. We LOSE 42.77 every month on this script (trying to fix that). She does the injection on tuesdays. We delivered it Monday. She called to bitch that it didn’t get there until 6pm. FUCK YOU BITCH! We lose money and deliver for free. GET FUCKED IN YOUR UNGRATEFUL ASS!

For every truly appreciative and trusting patient there are ten that wouldn’t piss on you if you were on fire.

Comment by brigid22 on 2011-01-05 00:59:49 -0800 #

I’ll flat out admit I love my pharmacists. As a nurse, I’ve dealt with a few that have pissed me off at times (they’ve all been with the same company…coincidence?) and I’ve dealt with some that have bent over backwards to help us out.
I have some knowledge with pharmacology, especially with the meds that I commonly give and of course, the ones for my own chronic health issues, but that doesn’t mean that I don’t ever have questions. And yes, I know I can look it up, and when I’m working, I do. But it’s nice when I get my prescriptions filled to be able to discuss my meds with my pharmacist (and they know I’m a nurse), and be able to have questions answered or even if it’s just me verifying that what I know about the drug is correct or if it’s for a different use than what I’m used to administering for (like when I was put on folate for anemia – my only exposure with the drug and the emphasis I had with it in school was on its role in prenatal development, but didn’t know that much about why I was taking it or anything else about it) and then getting informed.
The one thing I’ve learned in dealing with chronic health problems is that my pharmacist is my best resource. I can’t always figure everything out alone, especially on the days when I’m sick and tired and somedays I have more questions than others. My doctor is great, but I can’t just walk into his office and see him every time I have a question – it takes about a week to get an appointment. My pharmacists are the best resource I have when I’ve got a question, and, not just patients, but health care providers would be lost without you guys.

Comment by LadyHavoc on 2011-01-05 08:04:40 -0800 #

*hugs* I trust my pharmacist. My daughter was recently seen for an ear infection (yeah, big suprise, a 7 year old with an ear infection) by her pediatrician. I only brought her in because she spiked a fever of 102. The doc breezed in, peeked in her ears and said “yup, ear infection. Here’s some tylenol and amoxicillin.” And he promptly breezed out again. My daughter is allergic to penicillin. When I finally got her doc to change to another drug, I went by the pharmacy and dropped off her script. I didn’t bother filling the tylenol. I had that at home already. An hour later, my pharmacist called and wanted to know if I minded a generic since they didn’t carry the brand name. Same active ingredient, cheaper price, no penicillin since my kiddo is allergic.
The fact that my pharmacist is always ready to dispense advice, instructions, and answers, as well as pills, syrups and whatnot, means that he cares, and I care, even though the prices might be a bit more. I will pay extra if it means I get someone who knows what the flip they’re doing.

Sorry for the length. Thought you might need to know that some of us do care, and DO trust their pharmacist.

Comment by theragingintern on 2011-01-05 10:45:55 -0800 #

TAP, It seems that many patients have no idea what a Pharmacist actually does. I’ve heard numerous patients comment “what do you mean it will take 30 minutes? You’re just putting pills in the bottle!” This shit really gets me fired up. I wish the only obligation we had was to put pills in bottles. I constantly give sound advice on otc medications only to have the patient pick a different medication behind my back because they “…saw it on TV.” Complete joke.

Comment by pharmacyslave2000 on 2011-01-05 12:32:32 -0800 #

Great post TAP but you forgot to add entitled and ignorant to the “unwashed masses” description. It’s no wonder that we feel angry, jaded and dis-engaged. Our job description is not broad enough. It should now include insurance liason, secretary, doctor/nurse and detective (for those CII seekers). We are expected to be everything to everybody and it’s never enough to please anybody, neither customers nor corporate. The most frustrating issue for me is that we have absolutely no support. Our “professional organizations” are totally impotent and will cave at the slighest bit of pressure from the corporations, our state boards exist only to screw us over instead of protecting us and our employers are only concerned with making a profit at any cost. The general public has no idea what we do or why it is important, nor do they care to know. We are on our own.

Those that are not pharmacists will never understand and we can’t expect them to. For every one person who may truly appreciate our help and guidance there are 10 more who think we exist to simply stand in the way of them getting what they want as cheaply as possible. I don’t want to be on the “most trusted professional” list at all anymore. I simply want some respect and general courtesy every now and then from both the public and my employer. I don’t expect either anytime soon.

Finally, a question for the general public who may read this. Has your pharmacy ever advertised that you will receive the CORRECT prescription instead of advertising that you will A prescription in 15 mins. or less? If the answer is no, and it is no, you now realize what the problem is. Volume=profits!

Comment by 09pharmdiva on 2011-01-05 12:36:00 -0800 #

I felt like you were speaking from my heart. I’ve only been working over a year and I feel the exact same way. We go through soo much for people to just blatantly disrespect us. We have more at stake but they want it done in 5 minutes. I don’t know how many hrs I have wasted on phone calls with people who claim I made a mistake on their Rx but don’t know what the hell they are talking about. You just want to say shut the hell up I’m the one who went to school for this shit!

Comment by lovinmyjob on 2011-01-05 17:27:05 -0800 #

unfortunately, most trusted does not equal most respected. Respect implies unselfishness and too many of our patients just want what they want when they want it. They only see us as standing in their way and we are. We have the knowledge that they don’t and we stand in the way of them losing their life. Without sounding to “hokey” we are protectors of the public whether they like it or not. The drugs we dispense are dangerous substances or are used for serious disease states. Because of our training and education we make it look too easy to them so we can’t blame them for not understanding. It’s the nature of our business. I didn’t get into it for the kudos from the masses, but it sure helps

Comment by Pamala on 2011-01-05 17:27:11 -0800 #

I loved my pharmacy (I say that because the entire team was great). I loved it so much that even when I moved I would drive the 10 miles just to pick up my daughter’s prescriptions from them. Sadly they had a lot of turn over recently, and everyone but one person left so I had to switch because the kind of attention that I had before just wasn’t there anymore.

I switched to a new pharmacy. I spoke personally with the pharmacist. Told her of my daughter’s condition, the issues with getting her medication (you’d be surprised how the insurance company likes to think she doesn’t need her medication), the potential shortages that we see at the end of the year (Teva doesn’t always produce enough to cover all the kids taking this medication) and that I’d be calling it in early so that we could have time to go through the process.

I’ve recognized that the pharmacy is rarely the problem when it comes to refilling her medication. It’s the doctor’s office, in particular the nurse, oddly enough. She doesn’t do refill requests in a timely manner. She never does the appropriate amount of refills and sometimes gets the dosage completely wrong.

So I told the pharmacist that if she ever encountered problems with the doctor’s office to let me know and I’d do the leg work for her. Because I have no problem being a pest to the doctor’s office and I figure I have the time to do it.

By offering all this she now knows me by name even though we’ve only been there for three months. She’s on top of everything and keeps me up to date on what’s going on. I can’t complain at all about her.

Comment by Stop Crying on 2011-01-05 18:53:03 -0800 #

Wahhh, wahhh, wahhh you get paid a crap load of money to fill pill bottles. Boo hoo.

Comment by sumotoad on 2011-01-05 22:37:56 -0800 #

Back in the nineties, I was telling anyone who would listen “the only reason we are the most trusted profession is that, unlike doctors, lawyers, accountants and massage therapists, we are required by law to give away our most valuable asset– our knowledge.” We are required to answer the phone by law. We are required to counsel the patient by law. We are required to answer questions by law. And we cannot charge a cent for any of this. We cannot charge a cent for seeking prior auths, or getting the correct prescription, or for saving the patient’s life by keeping his doctor from killing him.

Comment by Disgusted Pharmacist on 2011-01-05 23:02:31 -0800 #

You know Angry–this is exactly why I always have to read your posts–cause truer words were never spoken. I mean really you are the one person who understands me and my frustration–my husband can’t relate. This is why when you say it is pharmacists who trust pharmacists it is key because I swear misery loves company. You verbalize my thought to a T !

Comment by PharmTech on 2011-01-06 01:16:36 -0800 #

Dear Stop Crying…

Please,,PLEASE come to my pharmacy one day. Please be in pain..or nauseous. I will show you JUST how long it takes to “fill a bottle of pills”. Oh..sorry..your insurance company needs me to call. Oh..sorry..can’t read your Doctors hand writing. Oh’re an ass and I think I’ll just make you wait. Let me guess? From your jealous comment I’m gonna guess unemployed and bitter? Lazy and on State assistance? Either way….hope you rot.

Comment by crusty rph on 2011-01-06 07:22:08 -0800 #

Walk with me, we need to talk.

You are missing the point. This site is for venting. Sort of like a newpaper, people only pay attention to the bad news, not the accomplishments. I used to think that I was paying my pharmacists a crap load of money for what they do, but now-a-days, being the middle man has turned into a thankless job. No money is worth the shit you take from some patients and insurance companies. We have let our profession become the whores of Health Care. Hopefully we will have a happy ending.

Comment by Sarah G on 2011-01-06 07:31:30 -0800 #

A pharmacist may have saved my life. Doc tried to give me a script for a penicillin relative when I’m allergic to it… RPh caught it. Another RPh caught a Seldane/antibiotic interaction for a script a co-worker gave her.

Reasons I don’t trust CHAINS as much, tho:

Comment by Hueydoc on 2011-01-06 20:11:05 -0800 #

Hmm…When I started my practice, I actually had an hour for lunch. Within two years, I was down to ten minutes and now I bring a lunch because I’m gonna work right thru it. We get pounded by the same idiots you do- both patients, insurance company preauthorizations, etc..etc..etc.. And unlike lawyers , we DO give away our knowledge free on the phone, which is why so many patients call us trying to get a refill of their BP meds when we haven’t seen them in two years- who knows what their blood pressure is doing ?
And when I get a medical student or resident assigned to me, the first day I send them down to the pharmacist to spend the day with them learning how the system really works ( and what all those TV advertised meds really cost).
So don’t rag on us much ( yes, some is justified) we’re being shot at by the same people.

Comment by hannah on 2011-01-06 21:25:08 -0800 #

To be fair — your idea of a nurse is as relevant to reality as the public’s idea of a pharmacist simply being a pill pusher. At least you can stand behind a counter and not get physically assaulted by a patient.

However, I trust my pharmacist implicitly. I routinely ask him questions about OTC stuff and, y’know, take his advice. Recently was put on quite a few meds for lung issues due to mold in my apartment. He went over every med with me and answered all my questions — probably not something that he had the time to do (I fill at WalMart) but, hell, neither did my doc and the doc just rushed out of the room when he was done.

As a side note, I miss the independent pharmacist. I’ve lived in small town North Dakota where we had probably three independent pharmacists. It kind of sucked because none of them would fill your hypothetical Plan B rx but the service was great and at least they filled my birth control. 🙂 I live in Kansas City, again, now and there isn’t a non-WalMart/Walgreens/CVS pharmacist within comfortable driving distance.

Comment by MNRPh on 2011-01-06 21:25:11 -0800 #

Yes, I remember the “Most Trusted” banner hanging prominently in my college’s building. Those initial delusions definitely trickle into TAP’s toxic river of truth. I am curious to hear from TAP’s pharmacy student fan community. What is their honest take on the profession as they negotiate the twists and turns from academic idealism to workplace realism? I am trying to get the discussion going at the blog

Comment by Stop Crying on 2011-01-06 22:01:18 -0800 #

If I’m in pain and/or nauseous I would go to my Medical Doctor for advice, not a Pharmacist. Then, he would call you and tell you to fill my prescription. I’d go pick it up later, and wouldn’t talk to you about what I need, or don’t need. Jealous? Not in the least, I have awesome health insurance and make a lot more money then most people my age. Keep mocking “State assistance” too, without Government subsidies there would be a lot less pharmacists complaining that they get paid well in to six figures. Hope I rot? Right back at ya!

Comment by WrongAid on 2011-01-07 06:24:58 -0800 #

I think I speak for most (even though most won’t admit it) when I say I regret my decision to go into pharmacy. After the initial high of those first few paychecks wear off you then realize you are staring down the barrel of a 40 year career in a job no human being could like or appreciate. Anyone I see talking about going to pharmacy school, I do my best to talk them out of it. If you think this job is bad now, wait a few years when several thousand students are graduating without a job to go to. You will see the true nature of these corporations when a pharmacist no longer has any leverage on them.

Comment by niterph-pacingmyselfsargeant on 2011-01-07 18:41:59 -0800 #

I think the general public has NO idea what we do. Like the old Seinfeld joke, I’m sure they think all we do is take some pills from a big bottle and put them in a little bottle, and then type a label to put on it. Therefore, we are “trusted” in their eyes because it is pretty hard to screw up pouring and typing. As usual, the public is clueless as to what we do, and honestly could care less about how many hoops we have to jump thru to get their prescription ready. That’s why they sing our praises ONLY when it is ready in ten and the copay is zero …. truly the only two good signs of a “good” pharmacy.

Comment by Mimi on 2011-01-07 18:44:25 -0800 #

I must be the only person on Medicaid who has never gone early refill meshuggah, even though i am on a controlled substance and 5 other meds for my conditions. I dont sell my pills, I need them and those nasty arse people on Medicaid who bother you great folks make me look terrible.

It’s funny. I was filling my meds at a new pharmacy, as my favorite pharmacist retired and I begged him to refer me to a colleague he trusted. So, I walk up, pass my scripts over, ask a few polite questions about a recent change, then handed over my Medicaid card. He seemed a bit surprised that I was so polite and well spoken.

I very much trust my pharmacist. They know stuff even my psychiatrist does not know.

A bit of background, I am currently on SSI for mental illness. I was in and out of the hospital last year. I go to a day program that has a mental health center attached to it, my new pharmacy is blocks from the center, I can kind of tell that the staff hates dealing with us day programers. I understand why.

But anyway, I thank you all the same for this blog. I hope to get stabilized enough to work. I would absolutely love to go back to school and finish my physics degree. I don’t care if I need to scrub toilets to get me through school.

Comment by Ordinary Joe on 2011-01-07 20:08:18 -0800 #

No, most pharmacists are NOT CVS Caremark. A few 17 year old kid at the front do the most damage. Followed closely by ANYONE at Caremark. That is, until they’re getting their glands pressed on a speakerphone for the EXACT reason why our claim gets denied. I talked to two LAZY CSRs and my wife talked to 3. I finally put them on the speakerphone and put a flashlight up thier hiney – its the money and not because of any altruistic concern. Get over it; we all whore for our paycheck. I’ve answered customer calls from people with stripes, bars, clusters and birds on their shoulders, and I’ve NEVER treated even the most PO’ed SSgt the shiessy way these INS resps are scripted to. Thanks to the … Company for contracting with Pharm company that rates “D” at the NATIONAL BBB.

Comment by GE Rph on 2011-01-08 00:07:57 -0800 #

Thats a freaking laugh. your doc wouldnt even see you

Comment by Mike D. on 2011-01-08 00:41:30 -0800 #

Whoa — can anyone translate this into English for me? What the shit is this guy talking about?

Comment by niterph-pacingmyselfsargeant on 2011-01-08 12:29:32 -0800 #

Agree totally. I used to be a “Wrongaider” btw, good luck with everything there. Yep, I’m in the 25th year sentence of my pharmacy career, and I’ve never heard of ANYONE recommending pharmacy as a career choice…and it’s usually a “I forbid you to go into it” voiced by pharmacists to their kids. Every 4th or 5th year intern I see, I tell them: “So you still got time to change majors … that’s great.”

Comment by niterph-pacingmyselfsargeant on 2011-01-08 12:32:13 -0800 #

Not a clue. Maybe if you take every 17th letter of the post, it will spell “Pharmacy blows”.

Comment by bcmigal on 2011-01-08 14:29:30 -0800 #

Lovinmyjob is correct. Most trusted seems to equate to least respected. I work with an extremely bright and competent college student/tech who once had pharmacy school aspirations. Needless to say, he is now pursuing a different career path. His reasons: the public does not respect us and neither do our employers. We are given more and more stupid tasks to do with less and less help. There seems to be more emphasis on these exercises and the speed in which they are performed than on accuracy and patient safety. We are required to have at least 20% “waiters” ie: rxs promised and filled in 15 minutes or less. Otherwise, we will be “coached” (a euphemism for “written up”.) It is difficult, if not impossible, to take a meal break. But if we do not, then we are also written up for the “meal penalty”. No overtime is allowed, but I cannot think of anyone who is able to complete their work while on the clock….this situation is so widespread with no solution is sight. Trouble is, there are 5 folks in line for one one job!

Comment by pharmacyslave2000 on 2011-01-08 16:27:44 -0800 #

What happened here? How did “clusters” and “birds” end up in this?

Comment by Rivalry on 2011-01-09 14:15:16 -0800 #

He’s talking about military insignias. Lieutenant, Colonels, Generals, etc. Ssgt = Staff Sergeant.

Sounds like he’s complaining about insurance reps being rude, which I mostly agree with.

Comment by Marie C. on 2011-01-09 14:44:34 -0800 #

Here are a couple of ideas:

Throw the drug co owned/ins owned and MD lobbist owned people out of Congress-Now.
Make congress 4 year terms for both Houses and max of 2 terms thereby making it very expensive for drug co/ins. co and MD lobbbist to BUY the Houses.

REQUIRE medical education in schools beginng in 1st grade. The idea that “Johnnie” is taught this is his nose but then not how it works is a waste of my tax money. And a waste of my time telling the same people every cold season the same recommendations year after year.

But the big ? is why people are still going into the Practice of Pharmacy.
If they build it and no one comes what then?


Comment by rph3664 on 2011-01-09 16:51:59 -0800 #

Marginally OT: What’s this about that new Wellbutrin knockoff whose name escapes me right now, but is bupropion hydroBROMIDE and costs an arm, leg, and your first born child?

Comment by Commonsenserph on 2011-01-10 22:30:59 -0800 #

Tap, you forgot to mention the tyrant corporation such as CVS CAREMARK
who will use the situation of over supply of pharmcists and now firing any pharmacist who doesn’t meet their definition of business metric goal. Just recently, DM and Pharmacy Supervisor terminated the pharmacist who practices best pharmacy practice performing DUR, calling MD for overusage of Narcotics and warning the MD for overusage of medication that might harm the patient’s safty because of a couple of drug addicts were complaining that the pharmacist refused to give them the meds eventhough the pharmacist explained the circumstance for calling MD completely in very professional manner. ( I heard the entire conversation since I was working.)

Now I know why CVS CAREMARK DM and Pharmacy Supervisor were acting like God it is because of over supply of pharmacists in the market.

Now, I am working with phamacist who is not up to par and I am working like a dog and I don’t know how much longer I can take the pressure and stress.

I miss the old pharmacist!!!

Comment by handyr on 2011-01-11 13:13:40 -0800 #

You do have a point about government sponsored insurance. The fact is that all those Medicaid patients do keep us working. After many years I’ve learned that its best just to hold your nose (literally sometimes) and crank out the scripts. It IS fun to bust on these assholes though!

Comment by Mellee on 2011-01-11 20:41:58 -0800 #

I am a customer or patient or whatever. Before I started to read TAP and TAestP I was the type of person as you would describe as a “crackhead”. I didn’t give a rats ass about my pharmacist and I used several pharmacies, usually to use their coupons. I was on medicaid some stores had my medicaid number and I had some stores reserved for the freebys and the extra narcotics, (or Vike O Dans) that couldn’t be billed to medicaid cause it would be a “refill too soon” I think it was 2 or 3 years ago I think I began to read TAP’s rants, I have read everything he has written. I have changed in those years. I followed much of his advice, I have 2 pharmacies one for me and one for my son. I don’t complain about how much time it takes to fill a script, (although I did once a week ago when Wal-Mart’s wait was overnight and I needed the meds asap) I don’t stare him down, pay for everything at their counter, interrupt him in counsultation. I even went to rehab, and it was a pharmacist who confronted me, and I fessed up, he began a process between himself and my doctors that eventually got me clean (3 years and counting.) So as a patient/customer/whatever, I honestly do trust my pharmacist.
and @stopcrying, take your own advice and stop crying you stupid ass crackhead!

Comment by FarmA-SeeSaw on 2011-01-12 21:41:23 -0800 #

I’m not so sure we have 40 years left in this profession, WrongAid;
While it just _might_ be better job security than your average mid-level bank manager (for now), I think automation and the collapse of service industries in the current Greater Depression is going to decimate us.

Picture the pharmacy of the future; The customer is met at the counter by a pharmacy tech. Dispensing is entirely automated, and the machinery is run by a pharmacist remotely sited–in Mumbai, India! The pharmacist, Rajneesh, can discuss medications with the patient over the store’s internet, but there’s a two hour wait…

There will be three pharmacists left in each state (one for each Chain Store, plus a 3rd for all the hospitals) so that customers have someone to sue when the single drug paid for by the Government Universal Mandate forumulary does not work…

Comment by Jenny on 2011-01-13 23:34:17 -0800 #

Love it

Comment by Irishpharmer on 2011-01-14 05:33:03 -0800 #

I see Community Pharmacy across the pond is also an unmitigating nightmare as well. Pharmacy in the UK is just a conveyor belt of scripts, there’s no joy in the job anymore. Hospital or Industry are the only the alternatives.

Comment by LD50 placebo effect on 2011-01-15 19:19:05 -0800 #

After the initial training, a few first jobs, and settling into ‘that’ routine job to save money for home and college for the kids, then it was time after 25 years to get back around to doing something for myself.

I went back for the graduate degree, did the non-traditional program rotations, quit the old job and picked up a part-time job, and left the rest of the options open.

I like what I’m doing, subbing for solo pharmacists in small hospitals in the general vicinity, picking up consultancies, and just generally doing a variety of different things in pharmacy. Maybe when I get to where I think I know enough about what’s going on in this area I’ll run for a political position, or teach health, biology, or chemistry in junior high school, or apply for state pharmacy inspector.

There’s no shortage at all for experienced pharmacists in this whole mid-eastern state. New grads aren’t interested in these little hospitals because they don’t have enough experience AND they’re hungry for money and security.

Most of the pharmacists in these small hospitals as director/sole pharmacist are in my age group mid 40s early 50s. We are not pressured to be cutting edge, just do the best we can with what we’ve got to work with, and so we’re the experts in providing our clients with the most reasonable tried and true therapies.

I started out my career wearing support hosiery, and my legs have thanked me for it ever since, and as long as my legs hold out, I have a job in the pharmacy.

Comment by ace on 2011-01-16 06:34:48 -0800 #

Man, you are right on the money!

Comment by PharmIntern on 2011-01-16 11:08:35 -0800 #

“Oh hell, what do I know. I just put vicodin and soma in little bottles not fast enough to keep the unwashed masses from bitching and moaning. Yeah yeah, it’ll be ready in 10, your ride is impatient.” <— HAHAHAHA totally true and sums up 50% of our practice.

Comment by starl on 2011-01-16 19:00:05 -0800 #

I worry about this on a daily basis as I work for CVS. Does anyone want to buy a house and 10 acres on a small river in rural northeast Florida? I just want to retire.

Comment by MellowMedStudent on 2011-01-18 15:14:21 -0800 #

So much vitriol against the doctors! Why judge the doctor, when you have never worked/participated in patient care in a doctor’s office? 10 minutes is two-thirds the time we are allotted to spend with one patient (courtesy insurance companies). 10 minutes is a lot of time out of the doctor’s day.
Many hospitals have 5-10 hours per week set aside for didactics, patient presentations, and miscellaneous seminars. During this time, various members of the community come and speak about the services they offer to patients as medical professionals. Examples of speakers include: psychologists, community nurses, social services, even insurance companies! Not once has a pharmacist come to speak at any of the teaching hospitals here in town.
Instead of snarkily complaining about physicians and ‘How they don’t resect you enough ((sob)),” why don’t you become a little more proactive, attend one of these seminars, and speak out about what you have to offer?
I should warn you, complaining being overworked when you get to go home at night and sleep (ever worked 18 hours straight then taken a weekend call, big guy?) is not going to go over well with physicians. So keep that in mind, should you decide to be a little more proactive.

Comment by theangrypharmacist on 2011-01-18 15:54:45 -0800 #

The /only/ doctors that are attentive to our needs are the attendings and the residents at a teaching hospital (which is due to the mentality at a teaching institution). Most of the other private-practice MD’s in town “dont have the time”, even if it involves a life threatening interaction. I’m expected to leave a message with some idiot who needs me to spell out ‘warfarin’ as they smack their gum on the phone then call me back with some half-ass solution that isn’t closely related to what I suggested.

Notice how I bitched about the doctors who dont read my change requests and take an hour lunch break? Thats private practice, not the residents (whom I very passionately defend when the patients refer them as ‘not real doctors’ – to the point of yelling at them).

Comment by OldPharmStudent on 2011-01-18 16:13:47 -0800 #

I think it has more to do with appearances. The doctor’s office is purely about the doctor who is in the business of making you healthy. Patients’ knowledge of pharmacy is typically only of the 60% of pharmacists that work in retail, most of whom work for big chains, and the perception of the big chains is that they are only in the business for the money, putting the pharmacist in the position of willing accomplice of bilking them of their hard earned dough.

Comment by niterph-pacingmyselfsargeant on 2011-01-18 22:16:50 -0800 #

18 hour days is a hoop you jump through for a few years, then it’s gravy forever…I only wish “I” had 10 UNINTERRUPTED minutes with each patient. Rphs, imagine serving 6 whole patients every hour!
You seriously think we should have to go to a seminar to tell doctors we know something about medications and disease states? it is to laugh.
When you start treating 3 patients at a time, figure out their insurance problems, answer 5 phone calls. call twits that can’t write rx’s worth a damn, while ringing up candy bars, tampons and other crap for customer during those 10 minutes…then I’ll listen to your argument. Until then, just talk to the hand.

Comment by bcmigal on 2011-01-19 10:43:40 -0800 #

My fondest memory is of the day I had to spell “KCL”

Comment by Ihatemyjiob on 2011-01-20 20:02:33 -0800 #

Most trusted? In a way it means a patient can spend extra time to ask questions that he/she is supposed to ask his/her doctor without paying a fee. Or a patient,coming in one minute before closing, asks what to take for his/her sore throat for several days. What even worse is a patient can yell at you when he/she does not get his/her vicodin.

Comment by Ihatemyjiob on 2011-01-20 20:18:19 -0800 #

I like the way you handle the first day of your medical student. Yes, our future docs need to know it is unethical not to refill patient’s BP med, inhaler, or sometimes insulin/OHA, but it is Ok not to refill vicodon.

Comment by Ihatemyjiob on 2011-01-20 20:32:31 -0800 #

Very true. The docs in teaching hospital are differnt from those in private practice. One time I have to page a private pratician to refill a 19 y/o’s BC because she has been out of the pills for three weeks. it was Sunday, that doc yelled at at why I paged him. I told him either you give the refill for her BC or I would call OC government that you will pay her \health family\ in the future. And I got the refill.

Comment by tthebingaman on 2011-01-21 23:01:18 -0800 #

I have to admit that after only a short amount of time working, it’s difficult dealing with patients who are so out of it that they can’t even tell me their own name correctly, who don’t have their insurance and expect us to magically “know” this already, etc. etc.

I know there are a ton of these on YouTube already, but I made another that hits on a few points I haven’t seen yet…I hope everyone here can appreciate the humor, even if it’s a little mean-spirited.

Comment by bcmigal on 2011-01-22 14:22:40 -0800 #

Please tell me what other “professional” has to work under our uber-stressfull conditions and be treated so badly by customers and employers??? Can someone name just one???

Comment by Sarah on 2011-01-22 19:05:28 -0800 #

THE ANGRY PHARMACIST? What a joke this guy is! I can picture him now…probably about 5ft. tall, coke bottle glasses, wears Armani shoes and Tim McGraw cologne, wears a pen behind his ear, has the techs call him “sir” ….he’s sooo sure someone is going to try and pull one over on him that he constantly is peering over his computer screen with his rodent-like eyes…he is QUITE IMPORTANT you know..I bet it takes him a few reminders by his “employees” to come and discuss a medication question with a customer, who has been patiently waiting for the past five minutes while Mr. A.P. sets a DOCTOR straight on the phone. ….Oh, wait, here he comes….click, click, click (little Armani shoes heading towards the customer in wait) Now, he has to be discreet when he pushes over a step-stool so that he can be as tall as the 75 year old woman customer who is in fromt of him. No eye contact…(A.P. is too important for that) no, he picks up the pill bottle that is in front of him of the counter, adjusts his glasses, purses his lips…”I ran this through but I AM NOT going to refill this again early. I have been on the phone with your insurance company and they NEVER fill early but being WHO I AM, I got them to let it go this time. However, Mrs. Cunningham, I am not your average Pharmacist and I don’t let little old ladies needing their Aricept EARLY throwing off my inventory! (right now the rat eyes are OMG…the bad breath…the squeeking of the Armani’s slipping of the foot stool….he’s now the ANGRY PHARMACIST!!!!! buahaaahaaa

Comment by Sofia on 2011-01-22 21:47:44 -0800 #

You are a moron. Bar-none.

Comment by Sofia on 2011-01-22 21:50:51 -0800 #

Btw, a pharmacist goes through equivalent education as an MD (ie. a PharmD, REQUIRED AS OF 10 YEARS AGO, BS Pharm no longer EXISTS ). 4 years of undergrad + 4 years of professional BS +/- a residency that may or may not be useful. Sarah, go back to your front-desk job.

Comment by I hatemyjob on 2011-01-22 21:51:54 -0800 #

One time I got a phone prescrition for \warfarin 3 mg, takin 1 to to 2 tab qday. I told the person on the other end \Wow your patient is very bright and he knows when to take one tab or two tab. Guess what, the other end replied \ I will call you back with new sig. I never got the follow up phone call. Then it is another story. BOB, I hate my job.

Comment by tthebingaman on 2011-01-22 21:58:24 -0800 #

Go fuck yourself, Sarah.

Comment by AngrierPharmacist on 2011-01-22 22:31:58 -0800 #

Most of our contacts with MDs are simple refill renewal fax requests interspersed with the occasional drug interaction problems. If you can’t handle responding to a simple fax form or a message (within a couple business days), I don’t worry about it. Not because I don’t care about patients – I do. For those patient requests you can’t/don’t respond to after a couple business days, I simply call those patients to tell them how incompetent their physicians and office staffers are, and I encourage them to call you endlessly until their situation is resolved. Unfortunately for you, that means getting paged in between your 18-hour workdays and on-call weekends.

It’s taken a while but now my patients are glad that instead of simply giving them fish, I’ve taught them how to catch their own.

Cheers, asshole.


Comment by bcmigal on 2011-01-23 09:06:41 -0800 #

So Sarah, I am sorry that you had a bad experience. The folks that TAP is referring to are those who seem to manage to leave the bottles of controlled substances behind on one of their many trips “out of town”. He is not talking about people on maintenance meds. We always (except in the case when an MD denies a refill) will “loan’ a few pills or work out a “discount” pricing for those who need early refills for legitimate reasons.

And, if i could stand comfortably for 8 to 10 hours straight in Armani shoes, I would buy them.

Comment by JennyR on 2011-01-23 15:28:43 -0800 #

I always ask, “would you like your RX done quickly or would you like it done correctly? ”

Ok that’s a lie, I never say that but I damn well fantasize about saying it. I’m really close to inviting them over the counter to “diy” if they are so effing sure.

btw, Sara , just because you’ve been waiting all but five whole minutes (omg) doesn’t make you an effing VIP or entitled to an answer before the person waiting fifteen – twenty minutes (before you I assure) for their medication.

Comment by Jeff on 2011-01-25 16:31:19 -0800 #

Why would you continue dispensing it at a loss? For the sake of argument, let’s say that it takes 6 months to get the problem resolved. In that time you are out of pocket $256.62, plus your time sitting on hold with processors, insurance companies, etc. Assuming that the processor allows you to back-bill for the older claims, you’ll be lucky if you make a gross profit of 5% on the product (most of which will be eaten up by the labor you used trying to get everything resolved in the first place). I would either tell the patient that our wholesaler doesn’t stock it anymore, so we can’t get it, OR tell the patient that their insurance company is paying undercost for the medication, so we cannot dispense it (and suggest that they give their insurance company a call and see if they can resolve it). Make it the customer’s problem… after all, it is THEIR insurance company.

Comment by Ron, PharmD on 2011-01-26 11:03:48 -0800 #

One thing I would add to the OP, is that even pharmacists don’t trust other pharmacists. Having worked inpatient as well as retail, I can tell you firsthand that hospital pharmacists look down their noses at the common, low-brow retail pharmacist. And don’t forget the biggest primadonnas of all: the clinical pharmacists who sneer with contempt at anyone who questions their my-word-is-gospel-because-I-read-it-in-a-journal attitudes.

Comment by Cassara on 2011-01-26 12:25:34 -0800 #

Hey TAP, I’m not sure who wrote this but its pretty awesome, I thought I’d share–

Comment by David on 2011-01-26 15:03:49 -0800 #

I enjoyed reading about what you have to endure and I’m very sorry! My question is: how do you know if a person changed it to were they would get another refill? Is it in a computer, or what?
I live in Tennessee and I am unensured. Now that I don’t have insurance are separte Pharmacies able to see the last time it was filled?
I never have asked for a refill two weeks early, but I have for one that was one week early. They would have never done it if I still had insurance! Does each place know exactly what you take and when the last time you filled your presribation, etc?

Comment by PharmDawg on 2011-01-26 15:58:46 -0800 #

I agree with Ron here, although I generally don’t trust other pharmacists education rather than them as individuals. If people go to a new pop up private school who will accept anybody, what kind of education do you expect? This is the exact reason the profession is going the wrong way, too much money in it for schools, organizations (APhA, NARD, State Boards, etc..), drug companies, insurances, and politicians. Why would anyone other than a RPh in the trenches want to change the good thing they have going? We really need a union to rally around and push for change. Pretty soon salaries will start plummeting and the profession as a whole will be overwhelmed by idiots working to pay off 100K+ in student loans for half of what we make now, then it’s a small leap to a world where we are no longer needed at all. All I know is that had I known when I started school what I know now about the direction our profession is heading I would have bailed and tried to get on welfare, or become an MD.

Comment by Mr. Dean on 2011-01-26 20:13:09 -0800 #

I happened to stumble upon the “Angry Pharmacist” and after reading through several of his blogs, I am really disappointed. Everyone likes a good laugh and sure, he can be funny but for the most part, it is at others expense…in a VERY CRUEL way. What surprises me more is all of the other Pharmacist’s that protect their leader as though he is Jim Jones and they are ready to drink the Kool-Aid! You all work in the same industry, and it is nice to be able to blow off steam. There are many other sites that adhere to the same type of banter however, when someone else that has an oppositional opinion of the “Pharmacist,” you all resort to the “F” word, telling people to “F” themselves, etc.. For educated people, those of you that are conducting yourself this way are a real embarrassment to your profession. I’m a teacher and I can take it so….go ahead, let me have it and I will expect for my post to be deleted. Have a nice day and get on Antidepressants.

Comment by Mr. Dean on 2011-01-26 20:15:54 -0800 #

Are you a Pharmacist? This is an ugly way to talk to someone else don’t you think?

Comment by dana on 2011-01-27 08:25:21 -0800 #

i have always loved this site. i am so sick and tired of the huge mass of dumbass customers that come in bitching moaning and groaning because they have to wait ten fuckinjg minutes for 3 fucking scripts or more. on top of all the stupid ass customers, we have to deal with the corporate assholes breathing down our necks pushing numbers at us every which way we turn in order to produce more scripts daily but still offer \supreme customer service. to all the corporate dickheads and annoying ass customers i proudly say \FUCK YOU ALL!!\ the longer i work in this feild, the more i hate people in general. i used to be a people person, social butterfly and all that other crap and now i avoid crowds of people and all interaction cuz i know they are all just like every other customer…

Comment by MellowMedStudent on 2011-01-27 16:21:47 -0800 #

Reading your comments, I realize that you have nothing to offer physicians, other than a lot of bitching and moaning (this is also directed at the comment below). Both of you need to go back to checking out tampons and checking for drug interactions (ie: using those computers).

Comment by MellowMedStudent on 2011-01-27 21:30:34 -0800 #

Sarah – You’re awesome.

Comment by MellowMedStudent on 2011-01-27 21:34:06 -0800 #

Sofia – get over yourself. A PharmD is nowhere near equivalent. And because I’ve done both (obviously you haven’t, or else you’d never have written anything so asinine), I’m gonna let you in on a little secret: a PharmD is about 25% of an MD, education wise.

Comment by theangrypharmacist on 2011-01-27 22:13:45 -0800 #

You’re a teacher, but you cant grasp the simple fact that this site is called the “ANGRY Pharmacist”, a site that pharmacists and other medical folks come to vent their frustrations?

No wonder why our schools are in the crapper.

Comment by letsrant on 2011-01-28 08:57:07 -0800 #

i always wonder why some pharmacists keep working the job they hate so much. i learned long ago that there’s no way i could work retails. 24/7 being the last to bear the brunt, no thanks. life is much more than bending over backward for nothing. find a different job while you can still appreciate life.
that’s said, being an MD is no appreciation either. patients demand to be treated per dr. google’s guideline, pharmacists complain about unreadable rx, insurance companies refuse to authorize needed procedures, management demands long hours and less pay, NP and PA compete for jobs, and when things go wrong, it’s on the MD’s head still… yeah i wouldn’t want to be them either.

Comment by letsrant on 2011-01-28 09:07:59 -0800 #

love it. a 5ft pharmacist with rat eyes, no wonder TAP is angry! anyone would if dealt that hand.

Comment by turkey on 2011-01-29 04:32:27 -0800 #

You’re a teacher, but you don’t know how to spell and punctuate the word “pharmacists”? And you capitalized the word “antidepressants”? What an embarrassment to your profession.

Have a nice day and go work on your English. And for God’s sake, stop stumbling around the Internet.

Comment by turkey on 2011-01-29 04:41:32 -0800 #

@TAP: When you said we were “trusted enough to know what isle the paper towels are on” I panicked — I couldn’t recall if it was St. Croix or Aruba? Ha!

Comment by NancyNP on 2011-01-30 10:20:14 -0800 #

I’m a nurse practictioner with over a decade in that position. Do I trust pharmacists? Mostly — I am deeply grateful for the (very few) times they’ve caught me in a dosage mistake; they have been extremely helpful in uncovering narcotics “double dippers” and schemers; I always take their calls & discuss their concerns and suggestions — even if I disagree, bouquets to all who care enough about their patients to take the time; and I hope I’ve always apologized for the times I’ve forgotten the “ER” or “XL” or whatever. And a special place in heaven for the ones that go the extra mile in helping with insurance tangles.
Here’s my biggest bitch about a few pharmacists in my community: the times the patient comes back to me, “Oh I didn’t get the prescription you ordered. The pharmacist said I shouldn’t take it because it interacts with my little blue pill” (or he said that old people shouldn’t take it, or he said its for epilepsy and my problem is my neuropathy — I’m not epileptic!, etc.)
What kind of unprofessional crap is that? Mr/Ms Pharmacist: you’ve got a problem with my Rx, call me up like an adult! Let’s talk it over! Don’t make me look like an idiot to my patient with these backstabbing remarks. 100% of the time when this is has happened, I’ve stuck with my original decision… I was aware of the interaction, but this is the best choice in a difficult situation….. no, this is really the best med for you even though you’re a senior …. and yes, I am prescribing the anti-convulsant for an off-label but widely used indication, etc. So now the patient doesn’t trust me or the treatment (and of course didn’t bother to call me at the time, so now we’ve lost a month in trying to address their situation). What a waste all around!

I’ll save my rant about your description of hospital nurses as mere gophers for another day.

Comment by theangrypharmacist on 2011-01-30 11:19:05 -0800 #

I’m going to hit on a few points that I think are interesting.
Point 1: Interactions. If there is an interaction, our asses are on the line for it. Thats pretty cut and dry. Even if you say its okay to fill, if we fill it – and death cometh – we’re standing next to you in court pleading for our livelihood. In fact, we are punished HARDER than you would because that’s sorta our job. Best way to deal with this? “Call me up like an adult! Lets talk it over” Tell us about the difficult situation and maybe we can offer an insight or two. At least you will have the CYA documentation as to discussed it with the RPh (and we would have the CYA of discussed it with the NP). All around the patient is aware that both YOU and I are on the same page here during this difficult situation so they will be less likely to sue if the shit hits the fan. I am however, sympathetic to your point. Unfortunately, much like there are bad NP’s, there are bad Pharmacists that will fax back if the computer even states there is a tiny, only seen on paper, never seen in real life, interaction.

Point 2: The most loaded question in pharmacy is when a person holds up a bottle of Neurotin and asks “Why am I taking this”. Gee, Neuropathy/Anxiety/Seizures/etc which do I pick. Plus (as you fail to realize) the little patient information sheets that we are forced to give out only have INDICATED uses on them. We aren’t stabbing you in the back, the law is. If you write on your Rx: DX: ANXIETY when you give Paxil or Wellbutrin, then we know to TELL the patient “Hey, your paper says depression, but you’re getting this for anxiety” and they say “Oh, good, okay”. If you are using shit off-label, we are reaching into a huge grab-bag of “why am I taking this” when we get asked. So don’t throw us under the bus because we’re just guessing why you gave the patient something off-label. If you cant spend the 4 seconds writing what off-label diagnosis on the Rx, then I dont have the 20 min’s to wait on hold to speak with you over why you are giving this medication.

Comment by Rex Henricus on 2011-01-30 16:58:20 -0800 #

Wow…everyone take a chill pill (I am soo hip) Now follow along esp. you druggists. You might as well settle in and absorb some truths.

  1. If you work for a chain your job is at best on the margins of the medical profession. You will save yourself a LOT of pain by admitting this before you start Pharmacy school.

  2. Doctors..Nurses..PA’s etc. are rarely idiots and if they are.. there is no way you can tell from your position at WAGS.

  3. The R.PH line is very likely to track that of the airline pilot. If you don’t understand this..start looking into it.

  4. After 20 some years (Vishnue help me) in the trade I don’t ever remember having any first hand knowledge of a real drug interaction much less getting hammered for one. I have probably directly saved one life.

  5. The fax is your’s easier for everyone.

  6. DO NOT fall into this job unaware (see 3. above)

Rex Henricus

Comment by theangrypharmacist on 2011-01-30 18:16:10 -0800 #

After 20 some years (Vishnue help me) in the trade I don’t ever remember having any first hand knowledge of a real drug interaction much less getting hammered for one. I have probably directly saved one life.

Bah, that damn Warfarin/Amioderone interaction is just in textbooks! So is NTG and Viagra! What about the Rx I got a week ago that was for Advair, Proventil, and Propranolol? That non-selective beta blockade is just bullshit!

Gimme a break. If you have only saved one person after 20 years you are either a professor, a big fucking liar or a mail order pharmacist.

Comment by I hatemyjob on 2011-01-31 07:51:45 -0800 #

Well, TAP, i feel the same pain. But PK and PD are the way that our Docotr of Pharmacy want to make themselves as important as Doctor of Medicine. But we all know it is very hard to prove that PK interaction will lead to any significant clinical outcome. Tell me how many times you have to call a doc to let him/her know that patient is taking statin and lopid together that has an increase risk of rhado. But look at the other way that is our job security. Just likt copy a prescription from another pharmacy, that is our job security too. Hahahaha

Comment by TxPharm on 2011-01-31 11:29:02 -0800 #

I work in a hospital and can guarantee that there are numerous doctors and nurses who are idiots.

Comment by pharnacyphil on 2011-01-31 16:28:22 -0800 #


In an average workday I feel more victimized than in control of what I am doing!
I started my profession with an extensive knowledge of drugs and information, enthusiastic, and an ability to flawlessly execute a 12hour work day with customer and employer satisfaction, and feel GOOD about it.

Today, in 2011. I head to work at the pharmacy with same full intent, and the same enthusiasm I had 30 years ago, and I invariably hit a brick wall!!
The job demands are surely different. The prescription volumn has increased, the insurance issues have us working overtime( priors, formulary changes, non covered meds, tiered meds and customer who don’t want to pay for them, etc).
The chain pharmacy initiatives are unrealistic, with low budgets and ever increasing programs, created by corporate pinheads, that demand they be monitored in REALTIME. (WTF!!)
Then there is the controlled substance situation…
where an RPh is designated to babysit the medication abusers without support of MDs and the state.
Then there are the shoplifters we have to chase down.The continual barrage of phone calls, drive thru customers who want to Wait!?!
Days go by with no lunch or dinner, rest room needs delayed till your bladder will burst.
But I am still in hope that life for a pharmacist in retail will get better, that is what keeps me going every day!!

But how and when will this happen, and IS THERE ANYONE OUT THERE WHO IS WILLING TO SUPPORT US????????????

Comment by Mr. Dean on 2011-01-31 16:58:28 -0800 #

Very astute of you Miss. Turkey.(aka, Angry Pharmacist) That was a test and you passed with flying colors. It’s reassuring to know that you know how to spell and punctuate as WELL as counting pills! Good for you. Now, go drink your Kool-Aid. No homework for you tonight, Missy!

Comment by Rex Henricus on 2011-01-31 18:20:26 -0800 #

I’m not too impressed with that reply Mr. Angry…If only I could drag you along into a world where things are going very wrong very fast and it’s all on you. Where the sweat is flowing and you are almost sick to your stomach. That has never happened to me in a pharmacy. In any case in about 5 years I believe that all of these verified interactions that you will be charting…knuckleheaded medical staff dealings…lifesaving activities etc. are going to be done for considerably less money. Chain pharmacists are so insulated (actually separate) from the real world of medicine that they don’t (can’t) even realize it. It’s like a bug-smasher jockey convinced that he could fly an airliner cause he read the operations manual. But as usual I digress. Hey, it’s a worthy enough job…just be very careful when you decide on it.

Comment by letsrant on 2011-02-01 07:13:26 -0800 #

ditto. same go for loads of pharmacists though.

Comment by Hueydoc on 2011-02-03 06:49:25 -0800 #

Thanks douchebag- now wait until you are in the real world and the pharmacists saves your ass ( and your patients life) by pointing out when you wrote a prescription for something that will violently react with what they’re already on- the prescription you wrote when tired. And if you think you’re working hard now, wait until you are a resident.
With your personality, I recommend pathology for you- your patients won’t have to put up with your personality !

Comment by mdb on 2011-02-06 18:56:48 -0800 #

I love dealing with most residents as they are usually great. Some still have the god complex going but you can’t fix all of them. I remember calling an office about a missing Z-pac script that the patient said was suppose to be called in. Took a day and a half for the office to leave a message on the IVR telling us that the patient could get benadryl over the counter and didn’t need a script.

I’ve also had to deal with idiots when I was an intern on rotations with home infusion and calling an MD about a vanco level for a patient who had been in the ICU for osteomylitis turned sepsis. The dipshit seemed to think a vanco level of 2.3 was okay and didn’t seem to care the current guidelines are 15-20 for the levels.

Comment by Pharmbuoy on 2011-02-07 22:15:44 -0800 #

Glad to hear that at someone out there appreciates all the time, care and attention that we pharmacist try to provide to our customers. A sincere thank you to you …

Comment by Pharmbuoy on 2011-02-07 23:03:05 -0800 #

Hey angry – you are my new best friend. Truer words have never been spoken. You have pretty much deciphered what our so called “profession” has been reduced to. And don’t get me started about those Jackass patients who fail to bring in their insurance cards and seem to think that we have some special telepathy that allows us to magically know just exactly what insurance they have. Let me ask you something … if anyone of us walks into a department store and tries to purchase something at the register WITHOUT a credit card they would most likely look at your like you are retarded and then throw your stupid ass out of the store. They don’t hold up all the other customers and ask you which bank it is through and what kind of card it is in hopes of getting a glimpse of some clue that may help them deduce what type of credit card it is … NO!! You get nothing! NO card no SERVICE. So what makes any of you useless dickwads think you can just march into a pharmacy and expect that they can magically solve your insurance woes ?? Get your heads out of your asses already. And, when you are unhappy about the crappy ass coverage that you have, take ownership of it!! After it is YOUR crappy ass insurance that YOU yourself selected so take a step back from the counter and scream and yell at your OWN stupid ass!!! Seriously!!!

Comment by PharmacyPhil on 2011-02-10 05:56:37 -0800 #

That’s right Pharmbouy, we foster a culture of people who exhibit less and less responsibilty for their behavior, as well as their LIVES. We need to incorporate “Have it your way!” into the constitution(lol). Taking 3 oxycontin daily instead of 2 ?, no problem we will take care of that for you! Xanax run over by the car in the driveway, no problem, we can fix that for you. I know I have active insurance, but have no information. You can take care of that, right? No Problem…
The only people who will not put up with this B.S. are government agencies. Try going to the DMV without the proper paperwork and see what happens. You will promptly get curb service!

Comment by GrumpyRxTech on 2011-02-10 09:34:14 -0800 #

That’s all well and good if you own your own independent pharmacy. But if you work for a chain, tell a patient “no” for even the most valid reason, and you’ll find out just how much your company not only doesn’t have your back, but also how glad it is to undermine its own bottom line solely in the name adhering to a laughable customer service policy.

You’ll get a call from your regional pharmacy manager telling you that you’d better damned well fill that Rx, bill the claim at a loss, and apologise to the customer for your “rude” (translation: rational) behavior.

Oh, and of course you’re giving that customer a $50 gift card. And it’s coming out of your bonus (if your company even offers you one).

Comment by Jen on 2011-02-14 05:52:32 -0800 #

I absolutely adore my pharmacists at my chain pharmacy. Regarding meds, I trust them more than my doctors (and they usually give me better information re:the meds). They typically go above and beyond to help me AND they remember me (which is probably because between my son, myself and my dog we get several prescriptions a week).

Comment by SaLLy on 2011-02-14 19:50:44 -0800 #

Voicemail was missing qty and Sig for Pen VK and the DEA/DPS for Vicodin. I called back to the doctor’s office for clarification and the heffer said, “I did leave instructions for the antibiotic. Take as directed!” And from that I’m supposed to calcuate the qty, day supply, and directions??

Nurse: Well how many tablets come in one bottle?

PharmD: Uh… 100.

Nurse: Okay, let me ask the doctor.

*holding* Why the hell does she want to know how many tablets come in one of my stock bottles??

Nurse. It’s 1 tablet qid for 10 days.

PharmD: Okay, on the Vicodin, you left off the DEA/DPS on the voicetmail.

Nurse: I already told a guy there that just called here. I’m not giving it again!

PharmD: Oh really, because we don’t have any male technicians working here and I just got this off the voicemail. NO ONE even knows to call on the DEA/DPS, yet.

Long story short, 5 minutes arguing back and forth, she finally gave me the DEA/DPS but read it so fast and said I was wasting her time. Well heffer, if you had left all the information on the voicemail to begin with, I wouldn’t have to call back. YOU’RE WASTING MY TIME. Obviously, you wasted another pharmacists’ time, too, because they also had to call back to get the DEA/DPS for a controlled substance you left on voicemail.

I showed up at that dentist’s office after work to complain to her manager. Instead, she came out and started talking. She eventually apologized and admitted that she was being rude, but ONLY because I was being so sarcastic to her about the qty and sig. Not her fault, she’s only reading what the doctor gave her. Well you know what, first off, she was JUST the receptionist. Not even a nurse or hygentist! Why would you let someone who has no knowledge about medicine call in scripts for a patient?! IDIOTS.

Comment by MellowMedStudent on 2011-02-15 10:26:06 -0800 #


Why is there a “doc” in your title? Are you a physician – or just a physician wannabee (ie: PharmD)?

Comment by I hatemyjob on 2011-02-16 14:58:34 -0800 #

Sally, you have my sympathy. But from A dentist office!!!!, do not get angry after all there was only two pages on their pharmacology book. One is for motrin the other is for amoxicillin. And I guess the end of each page it did have the quantity of stock bottle for each medication. As for vicodin it is a new chapter for him/her. Forgive him/her.

Comment by Hueydoc on 2011-02-17 06:43:25 -0800 #

M.D., you dipshit. A real one, unlike you.

Comment by HumbleYourself on 2011-02-17 20:59:33 -0800 #

Please step down from your soapboxes, everyone. We are a team. We need each other in this complicated, undervalued, and often overworked medical world — and it’s only getting busier with our aging population. Thank our Lord for the progress made to date, we can now love our grandparents well into their 70’s and 80’s. Please stop sharpening your claws on each other. No profession is better than the other, we’re all in this together doing the best we can with our part. I really enjoy working with nurses, dentists, PT’s [and other allied health professionals], physicians, pharmacists, and patients who strive to be successful at improving health. It’s the ones who are “better” than the other, or those who have NEVER made a mistake that scare me. WE ALL MAKE MISTAKES. But, we’re all here to help each other; finger pointing and backstabbing only slow the progress and disappoint patients. Thank you all for choosing a career to help our society and for doing your best at it.

Comment by Hueydoc on 2011-02-18 05:56:09 -0800 #

An ER doctor ?

Comment by Mr. Dean on 2011-02-18 12:55:10 -0800 #

Da Bingaman is a smoooooothhh talker <3

Comment by letsrant on 2011-02-18 12:55:23 -0800 #

a doctor at an indigent urgent care clinic? yeah, i’m bitter.

Comment by Mr. Dean on 2011-02-18 12:58:47 -0800 #

Why do you hide MellowMedStudent’s comments? He’s the only one on here with any substance and ideas of his OWN!

Comment by Hueydoc on 2011-02-18 14:06:25 -0800 #

I work in the ER now- I’ve been stabbed with a syringe, threatened with a knife, gun, spit on, puked on, etc…. And Admin couldn’t care less- except that I better get high Press Gainey scores.

Comment by Hueydoc on 2011-02-18 14:08:20 -0800 #

Why do I suspect that you are also Mellow shithead student, being a sock for him ?

Comment by Hueydoc on 2011-02-18 14:10:56 -0800 #

And I changed my mind- with your personality, I recommend you become a Hospital Administrator instead of a pathologist since you are already an a#hole.

Comment by Linda on 2011-02-18 21:53:03 -0800 #

I work several hours a day without a tech (some morning and some evening hours). I never tell anyone I can have their script ready in 15 mins anymore. I’ve found that people may whine about longer waits (when I’m alone it’s 30-45 min for one, 2 it’s 1 hour, and so on) or leave if they don’t want to wait for the time I give them, but appreciate and respect a true wait time and I have it for them when I claim I will have it completed. I also find they don’t come back and stare at me like a cow in the field waiting for feed and if they do I remind them of the time I gave them at the drop off window. I’ve also stopped having the techs (or myself) go to the pick-up area (including drive-thru) if the person is on their cell phone. I’ll look them in the eye and say, “We’ll be with you after you finish your conversation.” I’m tired of the disrespectful attitudes. I’ve also started informing patients when they scream “my medication is free” that indeed the medication is not free it’s just that they have no co-pay and I inform them of the cost of the medication paid by insurance or state-funded aid. One new patient today didn’t have his insurance card and didn’t know anything about his pharmacy coverage. I informed him of the cash price. He came back to the pharmacy later stating that his doctor said, “They can look up your insurance just by putting in your name.” I let the patient know that his physician is extremely misguided and that until he produced an insurance card for pharmacy coverage that he would be paying X amount for his medications.

We have to start demanding respect. You’re wrong if you think your management is going to fire you over demanding respect by your actions and words. I use the “no” word often with patients every day. I also use “that’s against the law” quite often or “pharmacists can be fined for doing/not doing” certain things. Just because some pharmacists bend the rules doesn’t mean you have to — and in the long-term you’ll get more respect from your counterparts.

If a patient comes into your pharmacy and berates your staff, simply hand them back their prescription and indicate they’ll need to find another pharmacy to fill it and then DOCUMENT the encounter in the patient’s permanent electronic file. Let them call your corporate management and complain — you documented it first. If someone yells at you regardless of the reason, send them away with their prescriptions — then DOCUMENT the living shit out of it. If the customer is a scary acting person, make sure you document that you were scared for yourself and your staff. Make your management abide by their own zero-policy workplace violence guidelines. Most states have zero-policy workplace violence guidelines — keep a copy with you at all times and use it to fire individuals that make your day at the pharmacy a living hell.

Comment by Agent Bristow on 2011-03-04 12:08:38 -0800 #

MellowMedStudent: Mmmm. really. And how do you feel about other doctorate degrees, such as epidemiology, pharmacology and biochemistry? Are those degrees also about 25% of your supposed better-than-thou medical education?

With a hubris like yours, it will be all the sweeter to eventually watch you fail.

Comment by dean on 2011-03-11 13:48:58 -0800 #

Trust is earned. A few months ago, my wife went to a local pharmacist to fill her prescription. They didn’t have enough to fill 100 pills so they gave her 90 and said to come back to fill the remaining 10. A month later we came back for the 10, and the pharmacist said, “Oh we filled it already.” We are flabberghasted. We obviously didn’t get those 10 pills, so who did? We asked the pharmacist if she checked the ID before she dispensed with the meds, and she said, no we didn’t because we don’t have to. She said if we want the remaining 10 pills we need to get another prescription.

A good pharmacist is like a good doctor or mechanic, they are hard to find. I have yet to find a good one that I feel I can trust.

Comment by letsrant on 2011-03-15 07:41:53 -0700 #

not sure why you guys give “dean” a bad grading. that is quite awful. i would not trust that pharmacist either. she obviously didn’t earn it. unfortunately those are the ones that give bad rep to the pharmacy profession. go to a different store dean. there are lots of good ones out there.

Comment by MurseTomM5 on 2011-03-22 21:44:49 -0700 #

It’s been a long time since I’ve been able to stomach a forum all the way to the end of its topic. I’ve been scanning various TAP posts, and it’s refreshing to see a group have a sounding board where they can play off of each other, get some meaningful outside insight and team up on various dip-shits.

Perhaps one day I’ll start something like this for Army ER nurses tired of dealing with the entitled hordes of politicians, soldiers, family members, docs, pharmacists, nurses (gasp) and others just as stupid and ungrateful of my profession and efforts as anyone else. Oh, what FUN: the joys of equal opportunity blasphemy!

You not-so-rare (last time I’ll acknowledge that on an angry venting site) nice and appreciative customers, patients and family members need not insert your hurt feelings here. WE LOVE YOU…most of the time. We hate you sometimes because you keep us coming to work, but no more than we hate ourselves.

Forgive me for temporarily hi-jacking pharmacists’ mental haven – the freedom and power of the web’s anonymity is hammering through my veins like all the drugs that it took to keep me calm then awake enough to stomach dealing with REMF’s (irony) and civilian patients after I got back from 15 months of heavy trauma in Baghdad only to one day get a bottle labeled motrin 180 degrees opposite and on top of it’s original label neurontin with three sets of verifying initials hurriedly inked in by two poor techs and a pharmacist tying to steam the firehose of patients before them and assuming that no idiot could mess up a prescription for motrin. Talk about a run-on sentence: try it all in one breath. Ready, GO! Never did get feedback from that ICE complaint or from that incident report, but oops, I show my propensity to go off on tangents.

I get your site, and I like it.

Happy ranting!

Comment by MurseTomM5 on 2011-03-22 21:53:17 -0700 #

That’s right, I mistook steam for stem…flay me.

Comment by Pharmer Bob on 2011-03-23 20:23:14 -0700 #

I loved this! I had a patient tell me the other day that it is not the pharmacist’s job to tell him when he can or cannot pick up a script, hydrocodone of course. WTF dickbag! That is exactly what their job is, why do you think they go to school for 6 years plus? To put stickers on plastic bottles and take care of all YOUR insurance problems? Get the fuck out! Needless to say I almost broke the headset on the phone banging it against the counter. Man am I soooooo glad I just got accepted into UT’s school of pharmacy. I love the good patients and pharmacy itself, but the insurance companies and crack head asswipes make it almost not worth it. I am just hoping that my job won’t be replaced by a vending machine when I get out. Wish me luck!

Comment by Pharmer Bob on 2011-03-23 20:31:41 -0700 #

Why did you wait an entire month to come and get the meds? I agree that they shouldn’t have misplaced them and it sucks when pharmacies run out of a drug, but we are human and we are not psychic. We are constantly fighting inventory problems due to outrageous costs of most medications so we try to have just enough to fill what we need so that none expires, oh here’s a new generic, good thing we just got twenty bottles of Tussionex in! I work at a shitty retail place and we fill 4000 prescriptions a week! It is quite understandable that 10 pills from a script that has already been sold are misplaced. I always tell patients to come back as soon as the med arrives and not when they need it three weeks later. Just because we are pharmacists doesn’t mean that you loose all of your own responsibility and common sense. I hate that patients seem to not be able to take care of anything on their own, take some fucking initiative!

Comment by PharmacyGirl on 2011-04-18 10:38:47 -0700 #

I work in the Prior Auth Dept for a mid-size PBM and can I just say that all of us (here anyway, I can’t/won’t speak for other PBMs) are PharmDs or Pharmacy Techs that have either worked in retail or hospital pharmacy so we do understand the plight of retail pharmacy. In many respects, we have the very same and in some cases similar (since we don’t dispense) situations where the MD says we should grant a PA becuase they said so. Or they fill out the PA form but not the patient’s info, or leave off the diagnosis, prev meds tried, etc. We welcome PAs from the pharmacy as long as you know the specific Dx, what prev meds were tried/failed and why (this one is always the issue), and what the rationale is. I know some PBMs like Blue Cross, Blue Shield, HealthNet, Caremark, Advance PCS, etc work very differently, we don’t all work the same, we aren’t staffed the same. I appreciate your rants and thank you for saying what so many of us think ourselves!

Comment by newname on 2011-04-23 12:53:06 -0700 #

Damn, you pharmacists sure are a bitchy lot. Yes, I’m sure there are many head cases you have to deal with on a regular basis, but that’s true for most of us. Not everybody who takes a pain med is a junkie. Just keep that in mind the next time you want to give someone a funny look for getting their ultram filled two whole days (gasp!) before they should be out. We non-pharmacists have lives too and maybe it’s more convienient to get something filled a few days before we’re going to be out of it. Actually, that’s just playing it safe. If you wait until you’re completely out, what if something happens and you can’t get the prescription filled on that day? We should be able to do that without any dirty looks or smartass remarks from you pharmacy workers.

Comment by Glenn Edgar on 2011-04-28 14:35:12 -0700 #

Maybe someone who counts pills every day and making over $100K, doesn’t deserve to have his butt kissed.

Comment by Kara on 2011-05-08 06:45:55 -0700 #

Well, you’re just a nurse. Trust me, you know nothing about pharmacology whatsoever because all you do is wipe asses and scurry to answer call lights, you fucking retard. And I know that for sure, since I’ve seen you at work.

Comment by Kara on 2011-05-08 07:05:21 -0700 #

Well of course he’s a doc wannabe!!!! EVERYONE wants to be YOU.

Comment by newname on 2011-05-12 07:18:12 -0700 #

I love you how you say the 10 pills were “misplaced”. No sir, they were either given to someone else or the pharmacist just didn’t want to fill the remaining amount. As fas as I’m concerned, pharmacists should always require ID from whoever is picking up a prescription, controlled substance or not.

Comment by Jamie on 2011-06-03 13:35:12 -0700 #

Well… I work hospital and I’ve got nothing but love for my retail counterparts. I did the retail grind for 5 years before running, screaming, for the nearest exit. Frankly, I’m more than a little proud to be able to point to many of my retail friends, knowing what all their job requires and say, “Yeah, I do what they do.” (Mostly ’cause I know its a big lie–I’m currently at work and reading TAP).

Comment by Your NameNo Nic on 2011-09-09 01:59:45 -0700 #

Term limits don’t restrict the power of corporate money. You just get freshmen who are bought from the get-go. Trust me, I live in Florida and our term-limited legislature is even worse than Congress.

The only thing that will end this mess is serious trustbusting, limits on corporate contributions and some severe hikes in corporate tax rates so they are forced to plow profits into the business side of the business and have less money to throw at politicians to get their taxes cut.

BTW, even if you do these things they will still break the law to kill the competition AND lobby those in power like hell to write regulations to keep up and coming competitors out.

Comment by Your NameNo Nic on 2011-09-09 02:14:09 -0700 #

Ha ha, I guess you never worked in a clothing store. Ever heard of the scumbags who buy a dress, wear it to the cocktail party (picking up wine and cigarette stains) and then try to return it?

And I have been on the other side of a cash register with someone with a FULL shopping cart who SWORE her check had cleared and how could the bank reject her charge?!?!

That was many years ago, but you get the point. The anonymity of retail or any of the mass employer service sector situations seems to bring out the worst in people.

Comment by redfoxrunning on 2011-09-18 11:43:34 -0700 #

It sounds like there are a lot of angry pharmacists out there, and I just have to ask, if the profession makes you so unhappy, why do you keep doing it? And on a side note, there are numerous professions (medical and non-medical) that have to deal with patients and customers on a daily basis; pharmacists are not the only ones who have to deal with these “idiot” patients, as they are so commonly referred to on this blog.

Comment by Ed P on 2011-09-27 23:27:53 -0700 #

He loves his job. He’s just venting with some of the greatest cynicism I have ever read. In a world where good people can be at their worst a Pharmacy is one of those places. Where people can be rude, and then you have the State, the DEA, the Doctors, the expensive presceiptions and the insurance companies to deal with. It where people can be manipulative and not understand he’s got to follow the rules or lose his license

I used to be one of those customers he speaks about. It was about 25 years ago and I was often told by my Pharmacist exactly what he has to tell some of his customers. Yea, 25 years ago and before I gain an appreciation of the hard work these folks do.

Comment by andinurse on 2011-11-09 19:43:23 -0800 #

pharmacy rocks! as a nurse it is my most ‘trusted’ way to get answers to patients that want ‘certain’ meds and why they may not be able to have them or what is a cost effective alternative. i have done 16-18 hour days, been spit on, hit, cussed at, had dr’s go into tirades and throw charts and NOW the new trend is lawsuits. oh freaking joy. so yes, nursing is stressful as well.

Comment by KaraSuckmyNuts on 2012-06-21 17:35:30 -0700 #

Kara, I hope that’s a fucking joke. Your probably a piece of shit troll. The woman is not saying she is some pro with pharm., just that she has some hands-on knowledge which would come with constant exposure.

I’m sure you know her at work too. Fuck you cunt.

Don’t use ‘just’, its belittles people. Your ‘just’ a bitch on the internet. I bet your ‘just’ a CNA, the one actually wiping ass.

Get the fuck over yourself.

Comment by KaraisMyBitch on 2012-06-21 17:49:45 -0700 #

He is making a point but is a complete ass. You can tell he is young too as he says ‘for my age’ which means he probably doesn’t make a ton.

Anyway, there is a lot of bitching and whining on this site. Pharm. must have a lot of BS and issues etc., but most places/careers/jobs do. It’s not wrong that this is all posted as its an outlet and I doubt you all feel this way constantly.

The career is worthwhile to you and I hope you all find that at the end of the day it was worth the ride.

Let’s just be thankful for what we have in life.

Comment by KaraisMyBitch on 2012-06-21 18:12:36 -0700 #

I hope you get hit by a bus. I can’t put into words how much I think you suck just off two comments you have made.

You are not god. You are most likely not even a MD yet, so who the fuck are you? A physician wannabe?

A PharmD is a PharmD, they have a doctorate in a medical subject (Pharm) and that is all. GO FUCK YOURSELF.

Comment by GB on 2013-01-23 11:55:22 -0800 #

How many times have you seen a patient dump all of their
pills right there on the counter only to count them

I’ve never done this, but in fairness, if I actually had cause to think that my Rx was coming up short, how else am I supposed to check that I got all of the pills?

If I took them home and counted and came up short, could I call the pharmacy and say “hey, the count was a bit off”? I doubt it.

Just sayin’.