pharmacy rant

... or how to ensure your pharmacist* hates you.

the most surefire way to make your pharmacist hate you is to show up on the morning of a tuesday following a three day weekend, when the pharmacy is understaffed and insanely busy, and say something like "did you have to manufacture those pills yourself, or did they just come in a bottle and all you had to do was count them?" this is akin to "its just a tube of cream, how long can it take?" but made worse by the fact that your snide sarcasm can't possibly be mistaken for simple ignorance of how a pharmacy works.

now hopefully those of you reading this have never made such nasty remarks, but trust me it happens far more than often than you might like to think. especially considering that i work in an "affluent" neighborhood... no, its not just ghetto drug seekers that are rude and inconsiderate.

in case you have never thought about what happens when you drop off a prescription, let me break it down for you. in theory, its not complicated; and quite often, if its not busy we can actually get your prescription ready in just a few minutes. BUT that is baring any complications and assuming you are the only customer around. which is unlikely.

#1: you drop off your prescription. in most cases, it goes at the bottom of the stack of prescriptions already waiting to be entered that were dropped of by others before you. just because you don't see anyone standing around doesn't mean you are the only customer. there are the drive through customers, the ones shopping around, and the ones that have left teh building with the assurance that they will be back in ten minutes because they need it AS SOON AS HUMANLY POSSIBLE. then when we do get to it, it must be entered into the computer based on what the doctor wrote.

the potential sources of delay at this step are ENDLESS... for instance, we ask if you've been here before and you say yes and then wander off to go next door to barnes and noble. only when we go to put it in, turns out you thought "here" meant the competitor across the street, and you are not, in fact, in the system at all. or your husband/kid/dog had one filled here, but your last name is smith, so there is no way i can guess, out of the 600 Smith families in the database, which one you belong to.

or your doctor did something that slows things down, like forgot to put directions, or wrote for a drug that doesn't exist, or wrote for an antibiotic that when taken with your heart medicine will prolong your QT interval (don't know what that means?? me neither... remember, i'm just a pill counting monkey) and we have to call them to figure out exactly what it was they meant, or to suggest they change it to a medication that won't send you into a fatal cardiac arrhythmia.

or better yet, your insurance has done something ridiculous like change your ID number or group number or send you a new card that you claim to know nothing about. or maybe they changed their coverage so that they no longer cover your medication unless your doctor gets authorization prior to filling it.

now imagine that this happens with at least half of the prescriptions that were ahead of yours... see where i'm going with this??

#2 your prescription goes into a queue with all the other prescriptions that have been called in, dropped off, etc. etc. we fill them depending on what order we got them and how soon they are to be picked up, honest. we're not out to make it take longer than we need to. and we know that of the ten waiters that dropped off before you, most of them won't bother coming back for an hour. but we have to treat them all like they will be back immediately, because if they do come back and their rx isn't ready, its our ass that gets reamed.

#3 now prior to this step, most likely everything has been done by technicians, the backbone of pharmacy. but technicians aren't pharmacists. and no matter how good they are, everything they did must be checked by a pharmacist. this is where our education comes in... the pharmacist not only makes sure that everything has been filled according to the way the doctor wrote it, but they also have to watch out for things like crazy doses and drug interactions.

#4 we call your name and you can pick up your med.


see, that doesn't sound too complicated right?? now keep in mind that there is typically only one pharmacist at a time. so no matter how fast the techs move, only one prescription can be verified at a time. so if there are fifteen people waiting ahead of you... its going to take longer than fifteen minutes. and this process i just described does not take into account all the other people who have stopped in to pick up medications that were previously filled, people coming through the drive through asking for cigarettes like we are their personal shopping service, the fact that the phone is ringing off the hook and that there is a line three people deep to ask questions like which is better motrin or advil?...

so how can you make sure that when your pharmacy staff talks about you, its in a good way? (because trust me, we talk about ALL our customers)

1. for the love of whatever deity you find holy, BE NICE. believe it or not, those are real people behind the counter and when things are crazy and we're having a shitty day, a little niceness goes a looooong way. i can't vouch for my coworkers, but i am far more likely to go out of my way to help you work out whatever complications you have if you asked what your options were than if you just demanded that i "figure it out." We get chewed out anytime something goes wrong, but its a rare day when we hear a "thanks" for spending ten minutes on the phone trying to figure out your new insurance coverage for you. oh, and btw, it is YOUR insurance... we have no control over your copays, nor do we know why they changed. that's why the insurance company puts that customer service number on the back of the card.

2. call ahead of time. most stores have a refill line, you should take advantage of it, after all that's what its for. i mean, its no skin off my back if you make an extra trip in just to drop off your empty bottle. i'm just saying it can save you some gas... and some frustration when you bring in seven empty bottle and we have to tell you its going to be at least 40 minutes until its ready.

3. be considerate of the pharmacist's time. don't get me wrong, we are generally happy to answer your questions. after all, we went through an awful lot of school (did you know that starting in 2005-ish all pharmacy programs are doctoral degrees?? so much for the pill counting monkey theory) and its nice to get to use what we learned. but keeping the pharmacist out in the aisle for half an hour talking about vitamins or bunions or your grandson's trip to florida is not cool. remember how i said there is only one pharmacist and a whole lotta scripts to check?? and not all questions require the pharmacist to answer, so don't just automatically ask to talk to the pharmacist. see if the technician that answered can help, if not, they'll let you know.

4. and the biggest pet peeve of them all. GET OFF THE CELL PHONE. technically we have to ask you personal information to ensure that you are getting the right prescription. that means asking for your address or your birthday. HIPPAA laws actually dictate that we aren't supposed to ask you personal information while you are on the phone, but more importantly its just plain rude. if the call is so important that it can't wait, you shouldn't have gotten in line in the first place.

now i actually rather enjoy my job, in spite of its moments of insanity. but there are definitely some patients that make it easier than others... so please, for the sake of a pharmacist near you, just keep that in mind the next time you head to the pharmacy.


*disclaimer: i'm not actually a pharmacist... yet. i'm currently an intern, which means when the shit hits the fan, i still have the luxury of being able to pass the mess off to the pharmacist in charge. at least until next year.