Friday, July 23, 2010

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.


Sara said...

I totally agree..I'd like to think I'm a good technician, not excellent.. but there are techs I work with that I really just want to pimp slap repeatedly. One has a new boyfriend that likes to take her drinking, add ditzy blond and you got it.. I caught two mistakes at PRODUCTION before the RPH even had to deal with it.. but of course some others went past me. These aren't just honest mistakes, they are careless. The ones I caught were simple, she imputed an Amox RX for the patient's dad instead of the child, and one was where the directions were right but the NDC was for the tablets, not the patches prescribed. It's very frustrating because it just makes us all look like morons.

Anonymous said...

First and foremost, I believe you have a hard time handling constructive criticism. Maybe the arrogance has obliterated everything except your ego.

A paper doesn't make the person, buddy. For example, Bill Gates dropped out of college. Look at how he handles his business and manages to do other numerous things while lacking his arrogance to start a foundation to help with global health awareness and knowledge.

Also, let me quote you again.

"On a personal level, it's not arrogant to state that I'm more intelligent than most people I meet."

Excuse me? According to the dictionary the definition of arrogance thus states

"offensive display of superiority or self-importance; overbearing pride."

You should already know that since you are so "intelligent"

First off, you are using 1st person. Secondly, you are describing yourself. It's evident you are exhibiting that behavior.

Either you are exaggerating or someone is not reporting your technicians' job performances. 40% of the time they make a mistake? How is this even possible? The margin of error is 5% before certification can take place. Also,
if she is that bad, why is she still there?

"In general, technicians aren't as smart as pharmacists."

That above statement I do agree with. If technicians were as smart as pharmacists there would be problems.

Also, I don't give you all negative feedback. I also gave you positive feedback.

It's your blog you are at freedom to write about what you please. It's also at my freedom to give my 2 cents as well.

I still do not think you are intelligent enough to handle someone criticizing your opinion. This part you do lack.

As you can obviously see, I am the 20 year old who you quoted in this post.

KoR_Wraith said...

Others can say what they will but I think you're right in almost every point you make on this blog - keep the posts coming, it's nice to read anothers thoughts so similar but better expressed than my own :).

Pharmacy Mike said...

I responded to your comment like that because you touched on a point that I would like to discuss. I handle criticism fine. However, just because someone gives criticism, doesn't mean you have to accept it without any discussion about it. Plus, your adding an emotions to my response when quite frankly, it wasn't emotional.

You are free to say whatever you want. You're free to completely disagree with me. You're free to call me a pompous, arrogant, asshole who is a hell of a lot dumber than he thinks he is. And, I'll publish your comments. My blog has never been one sided. Commenters have always been free to agree or disagree with me. However, if you disagree, I'll usually comment back in a way to support my view on things and argue against your view... if I disagree. I don't argue all the time, but only when I feel something is incorrect.

That said...

"offensive display of superiority or self-importance; overbearing pride."

Therein lies the problem. Who finds it offensive? How do you measure whether something is offensive or not? People take offense at a lot of stupid things. Who is to say what is truly offensive and what isn't?

Regardless, it also mentions that it's a display. If you met me in real life, I do not display any notion of superiority or self-importance because quite frankly I don't think I'm all that important, and I certainly don't think I'm superior to many people.

Like I said in my post, more intelligent does not equal better. It just means more intelligent.

If you met me in person or had a conversation with me, you'd probably like me... or at the very least not hate me. I'm a pretty nice guy... if "nice" means anything.

I just contest the notion that we have to continually be modest all the time. What's the point of being intelligent if you have to hide it all the time? One of the biggest problems we have in this world is that the most intelligent people aren't being listened to when it comes to making policy. Scientists tell us about climate change, then politicians with no scientific background debate whether it's true or not. Scientists tell us that there's going to be a huge energy crisis right around the corner because we're using up all the world's oil, and politicians and corporate CEOs tell us that they don't THINK that's true.

The brightest minds are marginalized in today's world. Eventually, very intelligent people have to stop taking a back seat to the lesser minds and shout out, "Hey! We know what we're talking about. You don't!"

That's the crux of my attitude. I hate it when I know what I'm talking about, and someone who obviously doesn't know what they're talking about has to be taken just as seriously as me. I used to be that guy that took the backseat and let everything slide. I used to let everyone have their opinions and stupid beliefs without contesting them. Not anymore. If you want to have a say on an issue, you better know what the fuck you're talking about, or I will rip it to shreds.

If that deep down confidence in my mind and my intellectual abilities is arrogance, then fine, I'm arrogant. If you met me, I don't believe you'd come away with that feeling though.

As for the techs...

There's no standard error rate they have to meet. No one in my company keeps track of mistakes. All I know is that when my techs input prescriptions (the 2 in the entire pharmacy that can), I'm sending most of them back to get redone.

Anonymous said...

You claim a 90-95th percentile on your NAPLEX? One, let's be honest, that claim is based on your powers of guessing of what the top scores were. Two, I don't think I would brag about that's only an entry level exam. Maybe try for a BCPS certification for some challenge in your life?

Frantic Pharmacist said...

I absolutely agree that the 'brightest minds are marginalized in this world.' Especially here in the U.S. we have forces that are hell-bent on dumbing us down and it seems to be almost admirable to advertise how much you DON'T know. Public figures today can make some of the most ridiculous, uninformed statements and get full news coverage simply because they are photogenic. I've worked with lots of smart people and also lots of clueless people who don't have even a cursory knowledge of current events, never read a book or newspaper, can't spell or do simple math. This is not good for our country or our workforce and I think it's a real threat to us in the long run.

RxKerBer said...

I know what you mean about hiding your intelligence. I feel ashamed when the subject of studying for school comes up, by techs or interns. I have been blessed with above average intelligence (was in RhoChi in pharm school and graduated summa cum laude). And it come easy and natural. There's not much studying I have to do to acheive. I learn by going to class, quick review of my notes, and know how to test well. It's just who I am. I don't flaunt it and even try to downplay it. But why should I? Does a super-model have to hide her beauty? Does Albert Puljols have to hide his talent? No,!!!! Why are smart people told they are pompous because they tell the facts of their accomplishments?

Anonymous said...

I agree entirely with Pharmacy Mike.

I have entirely average I.Q. and would have loved a career in art, however the practical aspect of pharmacy prevailed, plus the job provided a means to give back to humanity as well as keep in touch with new founts of knowledge.

I got through school on hours and hours of study, reading, and discussion in study groups. That's not to say that I'm stupid, nor have stopped learning after obtaining a post-grad degree. It just is that it took an immeasurable amount of work to finish, and continues to require study to keep up with the profession.

I do not like to see that others are presumed to be stupid, but on the other hand, it is fairly discouraging for me to realize about my fellow Americans to see so many wallowing in their ignorance like happy little piglets, not reading or doing anything intellectual, complaining about their 'lot' in life and not doing ANYTHING at all about it, and believing in all the inanity of current fads, paying allegiance to those with charisma or outward appearance or financial 'power', and even paying lip-service to belief systems provided by an American Christian religions (megachurch-style).

Pharmacy Mike said...

I got a 130 on the NAPLEX. 100 is the average, so I assume that's pretty good. However, the NAPLEX (as I've written about before) is a stupid, pointless exam. Honestly, I can't fathom how anyone can fail the NAPLEX.

To the previous commenter...

I entirely respect your work ethic, and I'm sure you do a better job than many people who are naturally gifted. Being smart doesn't mean much in itself. There are plenty of brilliant people who burned out and did nothing with their lives. Work ethic, desire, and determination will often get you farther than just relying on natural ability.

To RxKerBer...

It's not about telling everyone how smart you are. I don't run around telling anyone everything I've done intellectually. However, I know what I have done, and I know how hard others had to work to accomplish less than what comes naturally to me. The point is not to tell everyone you're very smart. The point is that you KNOW you're smarter than most, and you have confidence in yourself and your mind because of that.

Anonymous said...

I'm going to rant a bit now from the technician's point of view and see if we can come to an understanding of why things are like they are for us.

I have been professionally trained and worked very hard to become a nationally-certified technician. I work full-time for a supermarket chain. The biggest problems are the fact that certification is not required in my state so it is not recognized by my employer and the bottom line is what matters most.

We are timed on how fast we data enter prescriptions. We are required to average 21 seconds per rx. Speed is timed, accuracy is not. Therefore if I average 21 seconds on 10 Rx's and have 7 of them sent back for corrections, I meet the expectations of the job. If my co-worker averages 35 seconds per Rx and has none of them sent back she will be warned that her performance is unsatisfactory and she must either increase speed or face possible termination. My name tag has my name with the words "pharmacy technician" underneath it. The 16 year old guy they hired last month has the same title on his name tag as I do. We are equals.

Regardless of how much I love pharmacy and want to make a career of it, I cannot be promoted to head technician because you are required to have experience as a head cashier first. That's right. If there is an opening for a head technician at one of our stores, a head cashier who has never worked a day in the pharmacy and knows nothing about it is a better candidate that me, a certified technician who loves the pharmacy and wants nothing more than a career there. If I want to move up in the pharmacy, I will have to leave pharmacy and work as a head cashier on the front end and then hope that eventually a position opens up in the pharmacy again for me.

Also, speaking of head cashiers...why is it that I can be trusted to dispense and handle narcotic drugs, order and inventory several hundred thousand dollars worth of drugs, and bill insurance companies...all with nobody watching me, but if I need to refund $5 to a customer I have to get a head cashier to sign an approval form???

I understand your frustration, and I hope you understand mine. I don't want to be a pharmacist or I would have gone to school for six years instead of one. There are techs such as myself who are knowledgeable and dedicated who deserve respect. I show up for work in pressed slacks and dress shoes every day while my fellow techs are wearing sneakers and black jeans.

I would love nothing more than to be licensed and held responsible for errors that I make, but my state says you can hire part time teenagers as techs if you want. I'm seriously thinking about just forgetting the whole thing and leaving pharmacy. Perhaps this is a good explanation of why it is so hard to get good technicians.

Anonymous said...

Wow, to touch this topic. As being a PTCB and Lead/Head/Senior Pharmacy tech, what about the horrible Pharmacists that are out there. They think they are smart as hell because they went to school, but as a tech continually catch there mistakes. Everyone is Human and everyone has errors. I love your blog, but saying that most techs are horrible, maybe you should just do clinical pharmacology on a daily basis instead.

Pharmacy Mike said...

You're absolutely right. There are a lot of very dumb pharmacists out there. I worked with one. Actually, I've worked with several. They suck, and it's actually even less excusable than technicians who suck... because they're pharmacists!

I did not say that MOST techs are horrible. I stated before that there are a lot of great techs out there and that this post isn't pointed at them. What I said is that MOST techs are not as smart as MOST pharmacists. You have to admit that's true, and that sometimes, this can give pharmacists headaches when they're trying to teach them something or expect them to just inherently understand how to do something (i.e. not piss off a customer).

ros said...

Mike, I am stunned you have such inept technicians! Someone who has been there 20yrs and doesn't enter scripts? Only 2 out of 4 can enter a script???? How can the pharmacist in charge tolerate this?

Pharmacy Mike said...

It's a long story, but it basically has to do with how we used to be a very busy store without a script pro. At one point, we had at least 3 pharmacists working at the same time every day during the week. We had 4 pharmacists working on Mondays, and on Saturday there was even some pharmacist overlap for a little while.

My company allowed (and still does comparatively speaking) a lot more pharmacist help than other companies, which was a great thing. However, if you have 3 or 4 pharmacists working at the same time every day, what do the technicians do?

Basically, for over a decade, our technicians were basically cashiers. The pharmacists inputted all scripts. The pharmacists did all the filling. The techs put away the orders and rang the register. They never learned how to do anything because they never really had to.

Once our volume started to drop and the pharmacist help started to decrease, we were left trying to make do with techs that didn't know how to do anything. Most of our techs don't count. Like I said, only 2 can input a prescription, and one of those hardly ever works.

The only technician that we have that actually functions as a true pharmacy technician is our nationally certified tech. She does an OK job, but she pays very little attention to detail, and she can often be quite ditzy. She makes a lot of mistakes inputting prescriptions, and I end up sending a high percentage back to have her fix them... or I just do it myself.

The tech that's been there for over 20 years is afraid to touch anything in fear of screwing it up. She's pretty much a cashier. 20 years as a pharmacy technician, and she would not have a prayer in the world of working at another company like a CVS or Walgreens.

Our techs, in general, are extraordinarily untrained, and there's not much we can do at this point to right the ship. It's gone on for so long that it would be nearly impossible to change the way we do things now.

I always said I would love to be able to spend a day providing one on one training to each of our technicians. It's just really hard to train someone while you're trying to fill over 300 scripts per day... especially when the rest of the staff is untrained. If only one person needed training, it wouldn't be bad. However, to try to take the time to train every single one of them would be impossible. I'd have to be there on a day when I wasn't working, and my only responsibility was to teach.

Anonymous said...

Pharmacist Mike, I am glad I finally came across this blog. You are right on when you say that the technicians have a very low accuracy rate. And, you can well see, that many techs have the same attitude as the anonymous tech. A great many techs want what the pharmacists have worked so hard for and believe they deserve it. Technicians need to understand that most of them do not have the intelligence of the pharmacists and certainly not our training and expertise. Amen, brother. Oh, and by the way, that arrogance bit is just a cop out. I have been told the say thing. You just have to laught about it.

Anonymous said...

I am working as a pharmacy assistant in Australia and have an honours degree in a health related degree which required as much intelligance to get through as pharmacy would have. I was awarded 2 academic prizes, a 1st class honours and was in the top 6 academically of my class of 60 at the end of 4th year uni. Due to some personal circumstances (not career related) I choose to work in a pharmacy atm. Intellectually, I am equal, or smarter than the pharmacists I work with and know considerably more about some areas which customers enquire about than they do. I get paid $18/ I refuse to take on the responsibilities that the pharmacist is paid well for.