Let's Stop Pretending There's Privacy in Retail Pharmacy

HIPAA, HIPAA, HIPAA, HIPAA... Everyone's pharmacy employer pounds those 5 letters into us all the time. We're all concerned with privacy. Every time there's a privacy leak in a health care facility (be it a hospital, pharmacy, whatever), we all go ape shit about it. "How could this happen?" "Why aren't they more careful?"

I'm going to let you in on something that's not really a secret: THERE IS NO PRIVACY IN RETAIL PHARMACY. Now, that that's out of the way, we can all stop pretending and get back to doing our jobs.

See, the problem is that people are only selectively concerned about privacy. For example, many times some customer will get all belligerent because we'll ask for his address when picking up a prescription. "I don't want to shout out to the world where I live!!" (Of course, he has no problem loudly broadcasting how much of an asshole he is). Not to stereotype, but there seem to be more women worried about this one than men. It seems the skittish ones are always worried about someone following them home and raping them or something. Who knows? Who cares?

The big one is that we can't say the name of the medications our customers are picking up. It's a HUGE no-no to tell the world that John Smith is picking up Viagra or that wholesome looking Jane Doe is getting Valtrex for the raging case of Herpes she picked up from one of her wild weekends. I completely understand the desire to keep information like this private. Some of this is embarrassing shit. Therefore, it makes sense that a person might be a little peeved if some of this information was intentionally or unintentionally made public.

However, people only seem to be worried about privacy when it conveniences them. They really don't want complete privacy at all times, just when privacy doesn't get in their way.

Want proof? Here's a very simple way to illustrate what I mean. Go get your phone, and call your pharmacy. Make sure to speak to a pharmacist because all calls regarding this kind of sensitive material should be handled by a highly trained professional. Once you have the pharmacist on the phone, ask if there are any prescriptions filled for yourself. Ask for the name of the medication, what it's used for, and the price. I guarantee you that the pharmacist answers all your questions in his most customer-friendly tone of voice.

Now, if you're being consistent about this whole privacy thing, you should stop the pharmacist mid sentence as he's explaining your medication to you, and loudly proclaim, "YOU'RE VIOLATING MY PRIVACY!!!!"

I work in a pharmacy that fills a little less than 2,000 scripts per week. We have a lot of customers. I can match a face to a name of maybe 15% of our customers. Out of that 15%, there are only a handful of them that I'm so familiar with that I can recognize their voices over the phone. Therefore, any time I give out any information over the phone to anyone whose voice I don't recognize, I'm violating HIPAA.

95% of the time I don't have the slightest idea who I'm talking to over the phone. Someone calls and asks a question. I answer it. Someone calls and wants to know if a prescription has been called in for so-and-so. I tell them. I'll even tell them what it is and what it's for. I'm sure this is true of any pharmacy.

Have you ever tried to tell someone you can't give out information over the phone? The person gets all pissy. They don't care about the privacy laws in that instance. They only care about privacy when being private doesn't stand in the way of getting information they want at a time that conveniences them.

Here's another question: What percentage of prescriptions are actually picked up by the person for whom the prescription is filled? 30-40%? Maybe? It's almost comical. Seriously, try to keep track of who picks up for who one day. Most of the time, the person picking up is the mother, father, husband, wife, girlfriend, boyfriend, son, daughter, relative, friend, etc. of the person for whom the prescription is filled. We have no clue who any of these people are. If Jane Doe comes to pick up Jane Smith's prescription, most of the time, unless told otherwise, we'll just assume that Jane Doe is Jane Smith. We'll even offer to counsel Jane Doe on Jane Smith's medications!!! What kind of privacy is that???

In most cases, anyone can walk up to any pharmacy and pick up anyone's prescription. We don't ask every customer for ID. Hell, we hardly ask anyone for ID. Just about the only time anyone whips out an ID at our pharmacy counter is when they're buying pseudoephedrine products. There's more discretion in buying fucking Sudafed than there is picking up a medication for someone. Once again... How is this privacy?

You know what though? We want it this way. How fucking inconvenient would it be to have to show an ID for every pharmacy transaction? It would be incredibly frustrating to have to cut through miles and miles of privacy red tape just to find out over the phone the copay on your prescription. Let's all face it: We don't really want true privacy at the pharmacy. We just want the illusion of privacy. We want there to be just enough privacy protocol and procedures followed to demonstrate to us that the pharmacy at least cares enough not to blurt out your medical history to the entire store. It makes us feel comfortable and maybe helps us sleep at night.

It's all just an illusion though. Therefore, let's stop with the HIPAA pretenses and get rid of all that stupid red tape so that we might be able to more easily do our jobs.

I Feel This Needs to be Said

There are parts I agree with in your blog and parts I do not agree with.

Let's start with opposing opinions and then I'll state was opinions I share with you.

First, let me give you some background information

- I am a 20 yr old female college student, in school full time and working roughly 25 hrs/week part-time at a retail pharmacy. (no school this summer so I'm working more hours but you get the picture). I have worked at this retail pharmacy for 10 months.

I don't get why you give so little respect to your technicians? How long have they been working for you? Also, it's good to have them ask you questions in my opinion. Would you rather them shut up, make a mistake, you not catch up, and serious repercussions arise from this incident or spending 10 seconds out of your hectic schedule to answer their question? Are these certified/senior techs or what? In that case I could understand some but otherwise no.

Another thing is your arrogance is seemingly obvious. Let me quote you

"Moreover, despite being much more intelligent and more educated than pretty much everyone in the entire store, I ultimately have to answer to and follow the asinine rules made up by "head cashiers." Once again, I went through 6 years of college to get a doctorate in pharmacy. I graduated in the top 10% of my class."

Are you serious, sir?


Yes... I am absolutely serious.

I'll get to the tech thing in a second, but let me start with the arrogance accusation.

I'm sick of this prevailing attitude where intelligent people are not allowed to say or act as if they are more intelligent than others. Note that more intelligent does not mean "better." It simply means more intelligent.

On a personal level, it's not arrogant to state that I'm more intelligent than most people I meet. In just about every single way you can measure intelligence, I've always ended up in the 90th to 95th percentile. My grades, my class ranking, my grade school standardized testing scores, the SATs, the NAPLEX, my IQ. In all of these things, I've consistently been in that top 5 to 10%. Now, I realize that using any one of them to measure intelligence is obviously flawed. However, when you take into consideration the combination of all those things, you just have to state, as a FACT, that I'm more intelligent than most people. I'm not the most intelligent. There are a lot of people who are a lot smarter than me. I'm not a genius in anything. I'm just pretty bright.

That doesn't mean I go around telling everyone I meet that I'm smarter than they are. People don't like it when you boast about how great you are all day. It's fucking annoying. However, I do walk through life with the thought that I'm probably smarter than 90% of the people I meet. You call it arrogance. I call it confidence based on a lifetime of testing and evaluation. It's one of the few things about myself I am very confident in. That doesn't mean I think I'm always right. That doesn't mean I'm unreceptive of other people's thoughts, opinions, or suggestions. All it means is that I trust myself to make good decisions, solve problems better, and know more things than most of the people around me. I have confidence that I can depend on myself to correctly evaluate situations and come to a logical conclusion.

Moreover, this is my blog, and I'm not at all worried about offending the delicate sensibilities of random people on the internet. I hate being politically correct and having to watch what I say in order to not offend anyone. However, I do it in real life because, quite frankly, it's too much of a hassle to argue with people all day over stupid shit. Not a problem on my blog. I don't have to work with any of my readers. I don't have to get along with any of my readers. I can write what's truly on my mind, and if people don't like it, they can tell me in a comment, and we can have a nice discussion about it. Or they can not read anymore. It doesn't bother me either way. I'm not doing this to make money. I write a blog because occasionally it helps to put ideas into writing. Plus, it keeps my mind and writing sharp.

In addition, I used myself as an example of an intelligent pharmacist, but I wasn't necessarily talking about just myself. In most cases, the pharmacist is going to be the most intelligent employee in the store. It's just a fact. Pharmacists go through 6 years of what everyone always says is rigorous college courses in order to be certified a drug expert. You have to be pretty intelligent just to get into pharmacy school. Then you have to be even more intelligent to make it to the end of pharmacy school. I'd like to think that someone who has survived that kind of weeding out process gets the benefit of the doubt on being smarter (or at the very least more knowledgeable) than a career cashier or merchandise manager.

As for the technicians...

There are a lot of really great technicians out there who really do a good job. Unfortunately as in pretty much every other profession, the good ones are far outnumbered by the poor and mediocre ones. The technicians in my store are mediocre at best. We have 4 certified pharmacy technicians (one is nationally certified). Out of the 4, only 2 can input a new prescription, and when they do, they make a mistake probably 40% of the time. We have a tech who has worked in the store for over 25 years, and she absolutely refuses to input new prescriptions because she's worried she'll make a mistake. She makes over $20/hr and spends the majority of her day at the register or going through our doctors' faxes. She has nothing to do with the filling process. Our nationally certified technician is such a ditz that I'm afraid to depend on her for anything. She's in her own world for most of the day... that's of course if you can get her to do anything other than text message and take bathroom breaks.

I want my staff to ask questions because I don't want them to screw something up by trying to do something they don't know how. I answer all these questions without showing frustration. I try to help them. However, I also expect them to catch on and improve over time. They don't. It's frustrating, and it creates one more thing I have to worry about during the course of the day. I have to watch and listen for any sign that they might be making a mistake, which takes my attention away from filling prescriptions accurately and counseling patients.

It's not just my pharmacy either. If you look around the pharmacy blogosphere, you'll see countless posts about dealing with lazy, inept technicians. In general, technicians aren't as smart as pharmacists. Secondly, they don't care as much as pharmacists. It's not their licenses on the line. A lot of technicians are working part time while going to school, so they don't think very much about calling out sick on a sunny day when they'd rather be at the beach than work. They don't have that same sense of responsibility as pharmacists, and it shows.

Let me reiterate that I'm not including all technicians. I know there are great ones out there. I've worked with great technicians before. They help so much that it's impossible to overstate how nice it is when you're lucky enough to have a great technician. Therefore, the last few paragraphs are not aimed at the great technicians reading this. They're aimed at their coworkers.

Agree with me. Disagree with me. Comment. Email me. Ignore me. Whatever. I'm game for a discussion if anyone really desires one.

Twitter

As you can see, I decided to join Twitter. I figured that I've been having a lot of trouble writing full blog posts, but I still have a ton of observations I'd like to share. Therefore, it's a whole lot easier to Tweet a one sentence remark at the time of my observation than it is to save it up for a whole blog post later.

I will continue to add to my blog. I'm just having great difficulty find the inspiration to write at the moment. Twitter can sort of be an outlet for me in the mean time.