I'm sure many of you who read this will know the plight of the retail Pharmacist in the state of Florida...or will be one of my "Brothers in Arms" in the trenches here. We're mired in what I can only describe as the worst clusterfuck a Pharmacist could imagine.
I'm sure none of us expected when we went for our 4-6 years of Pharmacy school to become cops.
What I think it totally SCREWED is that the state has actually made it LAW (3 years ago) that we MUST verify that there is a proper patient-physician relationship if the person pays cash or has only controls.
I didn't know that not having insurance made you a suspect...what if you lost your job? What if you can't afford it at your job? What if you're self employed and don't see the benefit of the expense? MILLIONS of Americans are without insurance. Having only controls? That's way suspect as well. But, what if you are otherwise healthy and only have severe pain because you were in a car crash that left you with no cartilage and stretched ligaments in your knee as well as disc problems in your back?
Well, in Florida, in either of those situations, the LAW states that I MUST treat your prescription differently. I must call your MD and question him. What the HELL does that mean? you ask. I have no damn clue! I didn't learn diagnosis in Pharmacy school. What the fuck does "Pharmaceutics" "Professional Practice" or "Pharmacodynamics" teach me about diagnosis? Beats the shit out of me!
I ask the state inspector TODAY what it means to question the Physician, and he gives me the ever helpful answer of "Well, you question him to satisfy your professional judgement" I felt like screaming "What the fuck kind of answer is that? That answered my question with the same words rearranged into a statement!" I am untrained in what these diagnoses mean. Lumbago sounds really official to the lay person until you realize that it is simply "Generalized back pain of an unspecified origin", and you realize it just might be bullshit.
What's worse is that while the state is putting together different "raids" on pain clinics, they're not sharing this information with us Pharmacists so that we can be aware of what Physicians are being naughty fuckups. How are we supposed to avoid the "bad eggs" if you're not telling us which ones are not doing the right thing? Seems rather unfair, when a Pharmacist can be accused of trafficking in narcotics for filling scripts from the wrong MD....even if they are unaware that the MD office isn't being legit.
So, all of this leads to us asking ourselves what do we do? We can fill the prescriptions and hope they're not Pharmaceutical "Hand Grenades", or turn away the business.
Some of my colleagues down here love the idea of catching the bad guys. I say to them "Good luck and God Bless!" Say you do catch some doctor shopper at 10am and he goes to jail. If he's got any kind of loyal friends or attorney, he's bonded out by 5 or 6pm, which is hours before your shift ends. Never mind that his attorney will claim he's an addict and that his "addiction" led to his illegal behavior (It couldn't POSSIBLY be the 24" spinners on his 745Li or his Gucci everything). He'll plead down to simple possession and be back on the streets on probation or after 6 months in the county.
Meanwhile, you get to worry about him and his pals wanting some form of retribution for the inconvenience you caused him. And if he does shoot you in the face for what you did, what does your family get for it? Nothing...unless you have a life insurance policy on yourself.
Cops look at us as drug dealers too, and put us in the same boat as the MD even though we have no diagnostic abilities, and have no clue what's going on inside the room with the patient. How the fuck do I know if the Physician isn't examining patients if someone doesn't TELL me that!
Even our wonderful new Governor doesn't want to help us. He's looking to scuttle the registry that might give us the ability to determine who is shopping till they drop and avoid those patients.
Think your employer will back you if you get in hot water for filling the wrong prescription? Think again...they'll be the first to throw you under the bus and claim they had "No idea he was doing that sort of prescription filling".
I for one am not putting myself or my license at risk....my answer is fully 100% "I don't carry that". No other way to be in an environment where nobody has your back but yourself
Monday, February 28, 2011
A Little About Me
As this if my first blog, nobody reading this knows me...yet. I am sure, though, that if you are a Pharmacist and are reading this, you will most likely have experienced the same things.
16 years ago, as a 16 year old Junior in high school, I decided to enter Pharmacy School. I have mixed emotions about the results of that decision I made half-way through my life so far. At the time, I had visions of being in the healthcare field without having to deal with bodily fluids or bad news. I went to school and was trained to expect that Physicians, Nurses, and Patients would all rely on my "expertise" as a medical professional, and that I would play a vital role in the health of so many peoples. Furthermore, I would be a part of the "most trusted profession" as per some survey which we were never told the name of. I came out of Albany College of Pharmacy in 2001 with this very idealistic view of how the Pharmacy world would be. Then I got to my first position as a Pharmacist, and realized it was all....
BULLSHIT!
I was young, and even younger looking, so I would constantly have people direct questions to my clerk (a robust 55 year old guy who was more knowledgeable about what bar had the best happy hour than anything else) instead of myself. I would be shit on by customers who thought that telling me they lived on "Palm Beach" in Florida meant that their insurance couldn't possibly be rejecting their prescription. Having spent my entire 22 year existence in upstate New York, I didn't have a fucks clue where Palm Beach was...I lived in Boynton Beach and couldn't have given a shit about Palm Beach if you had paid me to. Others would ask for the older Pharmacist, to which I would have to explain that I was the only Pharmacist on duty and assure them that I was fully competent to assist their needs. I forged on.
I had a Physician right down the street from my location, who would routinely send customers from his office to my location on a Monday morning (when I would fill 450-500 scripts) and tell them to have me call him for their prescriptions. His patients, who I can only describe as THE MOST impatient SHITS that the world ever knew, would feel that they should be able to sit in the waiting area while I drop everything to call him for their prescription, then proceed to fill it all with 5 minutes or less. One Monday, when I had close to 200 already on the counter when 10am rolled around (mind you, we opened at 8am), I have this patient who wants to stand at my counter while I call for an antibiotic from this MD. I call the office and ask to speak directly to the MD. He comes on the phone, and begins to give me some attitude that I am calling him when he is busy, to which, I ask him for the prescription HE SENT THE PATIENT HERE TO HAVE ME CALL FOR. He recites the drug...of course Zpak #1 As directed...now how FUCKING hard would that have been to scribble down on a pad and give it to them while they were right in front of him? He tells me then that he's really busy. I respond that so am I. I ask him "Did you just have that patient at your office?" He responds "Yes". "And you didn't see fit to give them a written prescription while they were there in front of you?" I ask. "No" he responds. At that point, I am pissed and "Don't you think it's bullshit to send someone who's sitting in front of you out of your office with nothing more than instructions to tell me in the middle of a 450 script Monday to call you?" To which he tells me I'm unprofessional and asks to speak to the manager. I get the manager, and he proceeds to tell the manager I shouldn't use 4 letter words. I told the manager to call him back and relay that bullshit actually has 8 letters.
I had a district manager who was pretty decent. I signed a 3 year sign-on bonus and realized my mistake 6 months later. Sign-on bonuses are great as long as you didn't expect to get any payroll from your boss. I recall starting with 200 hours of "Tech/Clerk" help for the store, which was open 90 hours per week. That kept things moving quite well. When I left after my 3 years were up, I was down to 110 hours of help. That had me working Saturdays and Sundays manning the drop off, pickup, 2 phone lines, the fax machine, and the drive through solo.
I was then given notice that CVS would be taking over at the end of the summer. I was cautiously optimistic....but what a fucking dumbass I was. As an aside...every year, I schedule my vacation at THE SAME TIME...it's the last week in July, first 2 in August. This comes in to play next, when as CVS rolls out their "system transfer" schedule, my store is on the list to be changed over while I'm away. I call my DM to see if it can be changed. I get the response "Can't you change your vacation dates?" Well, gee....seeing as my oldest child was starting Pre-K, No, I couldn't change. I explain that every year, I have the same time off and that I have many members of my family and friends looking forward to seeing my family up there, and really couldn't change the time off. I am told "Don't worry...we'll train you when you get back". What a fucking joke that was. I come back after 3 weeks of rest to find out I have to drive 40 miles to get the training (mind you, my store was 8 miles from my house). I go up there to find out that the store I'm at is 75% done with their training, so I have missed the first 3 of 4 days of training. I get what I could only call a quick fuck in the ass training...missing most of the "meat and potatoes" of how to use their system....then I was dropped back in my store. What a nightmare. I've got a computer system that even if you put 99 prescriptions as the number being dropped off, somehow still told you that you should be able to give the patient a "15 minute wait". What the fuck?!?! I finally had my fill, and with 3 weeks left in my contract, informed them that I was giving a 3 week notice. My DM comes flying in the second to last day I'm there begging me to stay. He asks what it would take to keep me. my answer: "$75/hour and 4 weeks paid vacation" He actually began to call to work on it when I told him that even at $100 per hour, I wouldn't stay. Mind you, that was back when making $39 or 40/hr was considered very good.
I left for a local Grocery chain. For the most part, it's been good. I've stuck around for 6 years now, so that gives an indication. I still feel that many of these companies (my current one included) still feel that we are miracle workers who can turn lead into Gold. I guess I'm just happy to not be working in one of the big boxes.
16 years ago, as a 16 year old Junior in high school, I decided to enter Pharmacy School. I have mixed emotions about the results of that decision I made half-way through my life so far. At the time, I had visions of being in the healthcare field without having to deal with bodily fluids or bad news. I went to school and was trained to expect that Physicians, Nurses, and Patients would all rely on my "expertise" as a medical professional, and that I would play a vital role in the health of so many peoples. Furthermore, I would be a part of the "most trusted profession" as per some survey which we were never told the name of. I came out of Albany College of Pharmacy in 2001 with this very idealistic view of how the Pharmacy world would be. Then I got to my first position as a Pharmacist, and realized it was all....
BULLSHIT!
I was young, and even younger looking, so I would constantly have people direct questions to my clerk (a robust 55 year old guy who was more knowledgeable about what bar had the best happy hour than anything else) instead of myself. I would be shit on by customers who thought that telling me they lived on "Palm Beach" in Florida meant that their insurance couldn't possibly be rejecting their prescription. Having spent my entire 22 year existence in upstate New York, I didn't have a fucks clue where Palm Beach was...I lived in Boynton Beach and couldn't have given a shit about Palm Beach if you had paid me to. Others would ask for the older Pharmacist, to which I would have to explain that I was the only Pharmacist on duty and assure them that I was fully competent to assist their needs. I forged on.
I had a Physician right down the street from my location, who would routinely send customers from his office to my location on a Monday morning (when I would fill 450-500 scripts) and tell them to have me call him for their prescriptions. His patients, who I can only describe as THE MOST impatient SHITS that the world ever knew, would feel that they should be able to sit in the waiting area while I drop everything to call him for their prescription, then proceed to fill it all with 5 minutes or less. One Monday, when I had close to 200 already on the counter when 10am rolled around (mind you, we opened at 8am), I have this patient who wants to stand at my counter while I call for an antibiotic from this MD. I call the office and ask to speak directly to the MD. He comes on the phone, and begins to give me some attitude that I am calling him when he is busy, to which, I ask him for the prescription HE SENT THE PATIENT HERE TO HAVE ME CALL FOR. He recites the drug...of course Zpak #1 As directed...now how FUCKING hard would that have been to scribble down on a pad and give it to them while they were right in front of him? He tells me then that he's really busy. I respond that so am I. I ask him "Did you just have that patient at your office?" He responds "Yes". "And you didn't see fit to give them a written prescription while they were there in front of you?" I ask. "No" he responds. At that point, I am pissed and "Don't you think it's bullshit to send someone who's sitting in front of you out of your office with nothing more than instructions to tell me in the middle of a 450 script Monday to call you?" To which he tells me I'm unprofessional and asks to speak to the manager. I get the manager, and he proceeds to tell the manager I shouldn't use 4 letter words. I told the manager to call him back and relay that bullshit actually has 8 letters.
I had a district manager who was pretty decent. I signed a 3 year sign-on bonus and realized my mistake 6 months later. Sign-on bonuses are great as long as you didn't expect to get any payroll from your boss. I recall starting with 200 hours of "Tech/Clerk" help for the store, which was open 90 hours per week. That kept things moving quite well. When I left after my 3 years were up, I was down to 110 hours of help. That had me working Saturdays and Sundays manning the drop off, pickup, 2 phone lines, the fax machine, and the drive through solo.
I was then given notice that CVS would be taking over at the end of the summer. I was cautiously optimistic....but what a fucking dumbass I was. As an aside...every year, I schedule my vacation at THE SAME TIME...it's the last week in July, first 2 in August. This comes in to play next, when as CVS rolls out their "system transfer" schedule, my store is on the list to be changed over while I'm away. I call my DM to see if it can be changed. I get the response "Can't you change your vacation dates?" Well, gee....seeing as my oldest child was starting Pre-K, No, I couldn't change. I explain that every year, I have the same time off and that I have many members of my family and friends looking forward to seeing my family up there, and really couldn't change the time off. I am told "Don't worry...we'll train you when you get back". What a fucking joke that was. I come back after 3 weeks of rest to find out I have to drive 40 miles to get the training (mind you, my store was 8 miles from my house). I go up there to find out that the store I'm at is 75% done with their training, so I have missed the first 3 of 4 days of training. I get what I could only call a quick fuck in the ass training...missing most of the "meat and potatoes" of how to use their system....then I was dropped back in my store. What a nightmare. I've got a computer system that even if you put 99 prescriptions as the number being dropped off, somehow still told you that you should be able to give the patient a "15 minute wait". What the fuck?!?! I finally had my fill, and with 3 weeks left in my contract, informed them that I was giving a 3 week notice. My DM comes flying in the second to last day I'm there begging me to stay. He asks what it would take to keep me. my answer: "$75/hour and 4 weeks paid vacation" He actually began to call to work on it when I told him that even at $100 per hour, I wouldn't stay. Mind you, that was back when making $39 or 40/hr was considered very good.
I left for a local Grocery chain. For the most part, it's been good. I've stuck around for 6 years now, so that gives an indication. I still feel that many of these companies (my current one included) still feel that we are miracle workers who can turn lead into Gold. I guess I'm just happy to not be working in one of the big boxes.
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