Saturday, August 11, 2007


I started this blog with the idea to rant and rave about all the stupid/hilarious/infuriating shit that happens on a day to day basis in a retail pharmacy. I love reading other pharmacists' blog who do so, and since I have plenty of my own stories, I decided I'd share a little.

Now, I seem to have lost the heart to do so. I don't know why, but I just feel bad getting angry at our customers over this stuff. I laugh hysterically when other pharmacists do it, but I've found out that I just don't like sharing my own stories all that much.

Perhaps it has something to do with customers not knowing anything about how things work behind a pharmacy counter, especially those that don't use a pharmacy all that often. You would say it's common sense for someone to know that a pharmacy needs your date of birth, address, phone number, allergies, and insurance in order to fill a prescription for someone, but you'd be surprised how many technicians I've worked with who still don't understand this concept.

I remember the first day I ever worked in a retail pharmacy. I had just finished my second year of pharmacy school (4th year overall). I knew a lot (compared to my classmates) about medication, but didn't know dick about how stuff actually gets filled. Some guy walked up to the counter while the pharmacist was on the phone and put a prescription on the counter. I swear to you, I looked at the thing as if it was from another planet. I didn't know what to do. I wasn't sure what information I needed to get from him. I wasn't sure what I was allowed to get from him. After looking at the script for about a minute, the guy pulled it out of my hand, turned it over on the counter, and waited for the pharmacist to help him. The pharmacist explained that I was new, and the guy said, "I hope he knows what he's doing."

Now, I'm a pretty smart guy, and I like to think that I have at least a little common sense, but I didn't have the slightest idea what to do with the prescription. Now imagine someone who's never been to pharmacy school (maybe even never went to college), has no idea what the doctor just prescribed them, can't read the prescription, can't even tell if the name on top of the prescription is actually their name, and just generally clueless as to how the pharmacy actually bills the insurance company for this. All this guy knows is that at a pharmacy, he hands a piece of paper to someone, and then magically some time later a medication is ready for him.

Almost all situations where a customer gets angry are due to some sort of misunderstanding. It's not their job to know how prescriptions are filled. It's our job. They don't understand why their insurance company won't cover Crestor but will cover Zocor (generic of course). They don't understand how the generic can possibly be as good as the brand name medication. They think generic medications are no different from store brand foods, makeup, or something else like that. They've never been educated that generic products have the exact same active ingredients in the exact same doses and are tested to ensure they have similar bioavailability (yes, I realize that in some products such as coumadin and synthroid, the generics are not quite the same as the brand, but neither is better or worse, but just different).

Customers also don't realize that we have to put up with the same bullshit from doctor's offices that they do. There is no miracle pharmacy line with receptionists, nurses, and/or doctors waiting on the other end just to answer all our questions and approve all our refill requests. We get put on hold just as long, if not longer than patients do. Half of the time, the second we say we're from the pharmacy, they send us straight to a voice mailbox where we have to leave a message no matter what we were calling about. Moreover, the time when the most people are dropping off new prescriptions is right after everyone gets out of work, which just happens to be precisely when doctor's offices close for the day, and even though we still get prescriptions called in and faxed in from the office after it closes, we'd have a better chance of calling and speaking to the President than we do talking to someone in a doctor's office after hours.

In addition, generally customers know absolutely nothing about drugs. My mother works in healthcare, so I had a little bit of knowledge about which drug is in which product and what the products are for. Most other people don't know anything except what is advertised on TV. For all they know, Tylenol and Motrin are the same. I remember thinking I was a genius when I learned Motrin and Advil both contained Ibuprofen, which I learned was an anti-inflammatory drug, while Tylenol contained Acetaminophen which wasn't good for inflammation. How would you know that stuff without someone teaching it to you, and who could teach it to you besides someone with healthcare training?

This is why even though it can be infuriating spending 10 minutes trying to explain to some old lady that she doesn't need brand name Keflex (true example), I feel like I have to at least be understanding about it. That's why, even though I find it hilarious when other pharmacists write about how people can't even follow very clear and simple directions on their prescription bottle, I feel a little bad doing so myself. Medication is intimidating to a lot of people.

For example, "Take 1 tablet 4 times a day until finished." Those are typical penicillin directions. What can be more basic than penicillin, right? Well, which 4 times a day should he take it? She he take it every 6 hours? Should he wake up in the middle of the night to take a tablet on the 6 hour mark? Will something happen if he misses a dose? Until finished with what? The infection? The tablets? The symptoms? Someone who doesn't know anything about medication and is intimidated by it could conceivably ask all these questions.

Yeah... so that's my state of mind right now. I'm sure I'll write about stupid customers again, but I'll always feel a little guilty doing so. Doctor's offices on the otherhand.....


greensunflower said...

It is really hard when you realize your patients are human. But not only humans, vulnerable humans, who many times do not know how or when to defend themselves against our often times cruel world. Then we feel we need to protect them. I go back and forth between laughing at the idiocy to having my heart break.

I think finding the humor (not anger) in dealing with a varied population, helps with coping.

And when you get a nurse who doesnt want to hear jack shit about her drugs because she has lexi-comp on her palm /blushing/ you have my permission to post and laugh your ass off!

Mike said...

Actually, I understand what you're both saying, but I have to disagree with some of it. Don't understand generic equivalency? I'll give you that one. Not sure exactly what four times to take the PCN? Not a problem. However, don't know what your taking, why you're taking it, or if it's even your script? They're idiots! Most of the things we bitch about ARE common sense issues, not just pharmacy savvy common sense, but every day common sense issues. There's NO excuse for not being knowledgeable about this stuff! I equate this to the asses that eat garbage fast food for every meal and then want the judge to believe that they didn't know it would make them fat! If you're stuffing something in your gullet, it's YOUR responsibility to LEARN about it! I can't hold your hand all day, and "no", I will not follow you home to wipe your ass either! As far as them not knowing what drugs the insurance will or won't pay for, it IS there responsibility to know! They picked the shitty plan, not me! Their benefits WERE explained to them in the giant package of insurance materials that they scoffed at and then tossed aside! Of course, blame your school or someone else for the fact that you either can't or won't read it... After all, you're in America... It couldn't possibly be your fault... Just let someone else handle it all for you and then bitch that you have no control over you own healthcare! (end rant) LOL

Anonymous said...

I've dealt with the public for half of my life now between pharmacy and various other things and I have to tell you, you've got as lot of heart. Not only do you have truck loads of compassion for your patients, but you have an extremely selfless dedication to your job. I started out that way too, but bitterness, resentment and overall exhaustion soon followed. Don't end up like me...know when to laugh at them (while feeling sorry for them) and...know when to leave work at work and have your own time/life. It'll all balance at some point, and you'll be able to be happy and stay above the rest at what you do. Good luck!