Retail.... Retail never changes...

“War. War never changes.”

— Fallout

So I’ve been doing this ranting gig for 20 years. Be it via my website, twitter, a few youtube movies (that were hilarious btw), etc. It was recently brought up on the Discord server (link below) how my content that I wrote way back in the day was still relevant today. You’d think that after 20 years, the landscape of retail pharmacy would change. That things would get better. That the ranting about day to day life in retail pharmacy would somehow become obsolete.

Nope. Shit is shit no matter how much time passes. So I got to thinking, why? Why hasn’t retail gotten better? Why has it stayed the same (and in some aspects gotten worse)?

Two words: The Public. You know, the patients who walk in that us retail folk are forced to deal with while you clinical peeps hide behind appointments, closed doors, and a swivel chair? Yeah, must be nice huh?

Lets explore some reasons why retail is circling the drain while APhA deep throats CVS Health (still on your corporate supporter page, guess you haven’t learned).

Why do patients piss us off? #

Entitlement #

This fucking kills me. This one topic makes up for about 3/4 of my fucking rants. Just because you are poor, fat, stupid, and make shitty life choices doesn’t give you the right to treat me or my staff like shit. I don’t give two flying fucks who you are or how much of a hurry you’re in, you get to stand in line just like everyone fucking else here.

Yeah your fucking GLP1 has a $4 copay, and yes you must pay it. You’ll drop $20 on gas station garbage to eat but you can’t spend $4 on your fucking $1000 medication that might improve your health? You know that we’re losing money on this drug, yet you blow my clerks a ton of bullshit because “I dont got no $4”. Okay, then take a fucking hike.

“Oh I’m on a fixed income” has to be the old-person excuse that pisses me off the most. Its fucking $4. You smell like you crawled out of the asshole of a Virginia Slim cig model. I’m sorry if you’re too stupid to have priorities or the mental restraint to not blow your entire Medicare check (that we’re all funding btw) on casino tokens, a plastic jug of Black Velvet, and shit you impulse buy on QVC.

“Oh do I get a senior discount?” Yeah, its your $4 copay on A FUCKING 1000 DOLLAR ITEM.

Lack of patience #

Society was formed on standing in line. You stand in line at the grocery store, at the fast food joint, at the bank, at the DMV, in the bread line, etc. People in the UK call them ‘queues’ but since they monopolized the spice trade but refused to use any in their food, their opinion is moot and stupid.

However in pharmacy, standing in line is as painful as forcing someone to watch the new Wicked movies (you know, with anorexic Ariana Grande and that strange other chick). I should just put in everyone’s allergy profile “ALLERGIC TO STANDING IN LINE, REACTION: MAKING THEM ABSOLUTE FUCKING CUNTS”. Like yeah, your Rx isn’t ready yet. I’m sorry if we filled the last 5 Rx’s that the MD sent over only to have you just refuse to pick them up (“Oh I dont need those”) thereby making us undo all the work we did. Heaven forbid we point out your bullshit behavior to you. Oh you’re mad that we called you out on this? Well they had $0 copay so funds wasn’t an issue, it was your fucking laziness. Maybe you’re mad because we said what you really are, fucking lazy.

I swear to fucking god, if I get some asshole who comes in 10min until closing with a stack of fucking Rx’s and bitches about the wait time, I’m going to flip the counter and fucking punch that fat fuck in the fucking neck. Its always some mouth-breather who’s doctor is too stupid to send them electronically so they write out a bunch of hard copies. They come in as the gates are closing and say something fucking retarded like “Whooo I barely made it”. No you fuck, all you made was us fucking mad. Then you look at the Rx and they were written a month ago, so this fucking mental giant decided to sit on these Rx’s (that look like someone rolled them up, shoved up their dogs asshole, then fished it back out) for a fucking month and then now, 10min until closing, decides to bring them in.

Then to make everything just fucking more wonderful, instead of sitting there patiently wallowing in shame for making us all stay after we’re supposed to go home, decided to bitch about how long its going to take. Oh I’m sorry you welfare king, you must have a busy job you have to go to. Maybe its being a manager at the fucking degenerate factory. Or maybe its sitting at home fucking your ugly partner to pop out another degenerate child to be a burden on society. Birth control is free my man, so is Plan-B, but lets bake those creampies to get another mouth to take care of when you obviously cant take care of your own.

Lack of communication skills #

Patients have 3 moods:

• Happy
  • Its time for their Norco to be filled (But not the blue EWYA brand, those dont sell well and “Dont work”)
  • Its time for their Soma to be filled
  • Its time for their Benzo to be filled, but only if its Xanax. If its Ativan then see “Angry”
• Angry
  • Waiting more than 30 seconds for their 10 Rx’s to be filled
  • Their Copay is more than 0
  • Doctor put on the eRx when their narcotics can be filled, and its not today.
  • All other reasons
• Sad
  • Doctor denied their narcotics
  • Doctor denied their refills because they haven’t been seen in 6 months and no-showed their last 4 appointments. Oh who gets to break the bad news to us and get yelled at? Its us.

Can they articulate these moods into a coherent thought? Not a fucking chance. Sometimes it takes 20 min for them to get to the fucking point. Lonely old people are the absolute worse. They want to talk to a pharmacist about shit that has nothing to do with pharmacy or the meds they are on. Once I texted an MD asking if he could prescribe one of my patients a friend so they didn’t take 20 min of my clerks time talking about her life/day/week/etc while the phones were ringing off the hook.

Why has nothing changed? #

Technology/The Internet #

• Instant gratification
  • Amazon -> Next day Delivery
  • TV -> No commercials
  • Doordash -> No leaving the house
  • Grocery stores -> Delivery
  • AI (GenZ’s favorite crutch to get through life and be as lazy as possible) -> Shitty answers
• The ability to look up drug info instantaneously
  • Of course their sources are shithole sites like Reddit and message boards where everything is anecdotal and mostly wrong

COVID19 #

• People scared of their own shadow
• No contact with anyone
• Social isolation means they lose contact with reality
• Only friends are on the internet

The sad thing is that this isn’t only an US problem. Retail is like this worldwide. Ask any pharmacist from another country and they will say the exact same thing, even backwards places like New Zealand where they still use Erythromycin for everything

Hi ness <3 WOULD 100%

The whole debate about “Clinical” vs “Retail” Pharmacists. #

The only people who care about bullshit like this are clinical chuds, but hell I’ll weigh in.

I’ll be completely honest here. Any retail pharmacist worth their salt can be a clinical pharmacist. We dont have access to chart notes, we can’t talk to the doctor, we have to guess what the fuck they are treating, the ICD10 code on the Rx is 99.9% completely wrong (sure the patient has NASH while taking Librium and Antabuse), and we have to do all of this in 30 seconds or less while the patient is eye-fucking our foreheads and whining while we have 10 other things to do. We dont have the luxury of sitting down, breaks, chatting with colleagues or even a decent computer monitor to look shit up. We are doing 10 things at once all while the phones are ringing off the hook. Our best friend is a Magic-8-Ball trying to figure out what the fuck a PCP (and 2 specialists who don’t talk to each other) are trying to do here. You give a decent experienced retail pharmacist at most 2 weeks to cram on latest guidelines in the area they are going to be clinical on, and they can rock that shit AND not take shit from the uppity MD’s.

You put a clinical pharmacist in a retail situation, and suddenly the ivory tower the school/residency spoon-fed them comes crashing down. They would last at most 2 weeks before they had an emotional breakdown on making educated guesses without the safety-net of labs, chart notes and another pharmacist to ask. They would get tired from not sitting on their ass for most of the day in a comfy swivel chair. The younger pharmacists would go home and cry that a patient was mean to them and need a ‘mental health day’ because they were coddled their entire fucking lives and always told how smart they were. They have no fucking backbone and would fill every narcotic the moment a patient raised their voice, or deny a stage-4 cancer patent their opioids because “The MME is too high per the guidelines”. They have absolutely 0 common sense, and the act of thinking outside the box is completely foreign to them. They are so used to sucking MD cock that they would deep throat a bottle of lactulose just to feel something again.

The only redeeming factor of clinical pharmacists are those who put their time in the meat-grinder of retail and then pivoted to clinical. Those are the heros. Battle hardened in retail now fighting the good fight for us in the hospitals. Those are the ones who dont take any shit from the MD’s, give us in the trenches the intel we need to do our jobs, and are a phone-call away to help us out.

Clinical pharmacists take tests with an open book and notes. Retail pharmacists take tests with only with shit they learned 10+ years ago and under time pressure.

Come at me clinical chodes, oh wait you’re still looking shit up on Up2Date and asking permission to do your job from an MD.