What you probably never see nor hear about – behind the Rx counter

Now that I just spent my LAST DAY working as a community pharmacist I feel like I can get some things off my chest.
You should probably be nicer to your pharmacy.
I know this doesn’t include everyone. I know there are nice, polite, patient, understanding people in this world but I also know that when you’re sick, tired, exhausted, and ready to go home…..sometimes it’s a lot harder to be kind but you should try anyways.
I spent four years studying biology, followed by another four years studying medicine. I studied what the medicine was made of, how it’s absorbed, how it’s broken down, how it’s excreted. I know what it will do to you, what it will do when taken with other meds, what happens when you abruptly stop it, what happens when you never stop it, you name it, I studied it and believe it or not, as a pharmacist, I am on your side.

When you told me today you quit taking your antidepressant because it made you feel funny when you forgot to take it and you have gained 10 pounds, I wrote down the name of one that you can get by skipping a couple days with (it has a half life of about 3 days- fun stuff) that may also lead to some weight loss. Hopefully your doctor can get you a script for that.

When you dropped off your script for Mobic 10 mg… I called the dr and asked if I could change it to something that actually existed…it took a second but we got you covered.

When the urgent care np called in a script for your 6 year old last night that ended up exceeding adult dosages because they used weight based dosing and didn’t bother to check the max limits…I called and changed it because I did check them and I can’t imagine the diarrhea your kiddo would have gotten. My tech told you it would be 10-15 minutes. That’s before we knew it was written incorrectly.

The titration pack your doctor called in for your anti-epileptic wasn’t ready on time. I know. It was $250. We got it changed to the old school pills and included an instruction sheet on how to take it. You ended up paying $5 but it took me a minute to make that happen.

When your doctor sent a script over for a blood thinner that was twice the normal dose, I called to make sure it was on purpose. It wasn’t. No biggie, I fixed it for you.

Medication errors are the third leading cause of death in the United States (following heart disease and cancer, in case you were wondering). Pharmacists in your community pharmacy are trying to make sure an error doesn’t happen to you. When they say it will take 45 minutes to fill your script, give them the courtesy you gave to the guy who just took your pizza order (I am
assuming you don’t ask “why so long” when they give you a time)….say thank you, be patient and remember the pharmacy is on your side. We do a lot more than apply stickers with your name on them. We care and we are doing our best and we are going as fast as we can. If you know your pharmacy is great, let them know too because by the end of a twelve hour shift, they almost never feel that way.

(Also, if you’re still reading this, for the love of god, give the pharmacy your new insurance card.)

Many times pharmacists do things that the pt never has a clue about what is going on… Can’t count how many times that I would tell the pt that there was something that was not clear on the prescription(s).  What was more often the case was that your prescriber wrote for something that was contraindicated with existing medications, you were allergic to, the dose was too high or too low… dozen different things that were “just not right”.

I would take the “hit” for being “too slow” to get the prescription filled rather than tell the pt that their prescriber make a serious error that could have caused the pt anything from an unnecessary inconvenient side effect… to something more critical or even fatal.. 

 

7 Responses

  1. I LOVE my neighborhood pharmacy. I found out long ago they really care about the patients/customers and do everything and then some to get the best price on top of better service than any big chain plus, they even get to know your name! What an old fashioned concept. My pharmacists know more about medications than my docs do. They take the time to research and prevent errors and answer important questions. And they don’t make me feel like a drug-seeker. They know meds in and out. Additionally, they can sometimes offer cash prices which can be way cheaper than going through insurance. Fancy that! Did I say my neighborhood pharmacy charges less than any big chain pharmacy who’s ultimate objective is making big $$$? Smaller, hometown pharmacies and their pharmacists ROCK!

  2. In community/retail pharmacy, we see many, many prescription mistakes/errors all the time. Day in and day out, all day long. It’s done by all doctors/practitioners with all prescriptions — written, phoned-in , electronically sent prescriptions Wrong drug, wrong strength, wrong dose, wrong patient, incomplete prescriptions, etc. The pharmacist is the last line of defense. It he/she does not catch the error, it gets to the patient. If the patients knew how many prescription mistakes/errors happen every day at every pharmacy, they would be shocked and appalled. Now you know why no one talks about this.

  3. Thank you so much for all you do…, I do understand, that folks now a days seem much less patient…, then scream & want to point blame, even suing pharmacists for a mistake, when, in reality, we have ALL seemingly agreed to create this “too-fast” system, where much can be missed, where decisions are made by those in power positions which have, and keep us in jeapordy because time was never REALLY spent, or even given…, new policies are just implemented as if “the people” do not exist, or are considered…
    I am always awed, & amazed at my independent pharmacist, remain very grateful, & pray for him everyday…., I pray he can stay true to his Heart, and to his humanity…because it seems once one accepts funding/stimulus $ from Gov, even if at 1st it appears for a good reason…., I would then be scared…., (not that I would necessarily know!)
    Your all in my Prayers as I, too am suffering as I try to navigate this current pain medication reduction/with their intentions/threats to discontinue…., & I, as always continue to try other modalities, without the $ to do so, but am desperately wanting to end this demeaning hell of my current medico-political-industrial-complex nightmare!!!

  4. Steve, I send a lot of your posts to my doctor she wrote me back one day and said ” he’s your favorite” I said yes Dr and you’ll be seeing a lot more of his posts as well. Steve, I want to thank you for all you have done for our community and will do for us in the future. ☺❤

  5. Props to my pharmacist. He’s a good man. He hired good people. Friiendly, always know my name. I am so ill since the drop. Seems like I am on the phone constantly. They have so much trouble getting my medicine…even phenergan and scopolamine. They can’t get it for hospice patients because of the government. They are kind to me losing 40 lbs right in front of their eyes. Was on 2 meds before the drop, now 8 or 9..so expensive and I am dying from starvation from being UNDERDOSED. It’s torture. So anytime someone lightens my load when the chips are down…I never forget it kindness and always try to repay one. Can’t even imagine the stress and responsibility. Just dealing with insurance companies alone…holy hell.

  6. I truly believe that pharmacists have the hardest, most stressful job in the world! I love to pieces my Pharmacist and the other one who is there beside her. I’m old, 67, and my mother was a nurse who had a pharmacist she used who became the best friend our family ever had. He would move heaven and earth whenever she (or I) called, to get us things that kept us alive. My stepfather was a paraplegic with definite medical needs, my sisters and I had endometriosis when the term had barely been coined. When we had the stomach flu or food poisoning, he was there, sending the phenergran so my mother could inject us. I could go on, but another point I want to make is that that generation of pharmacists were so kind and compassionate.

    This is the way I see Steve. This man is a jewel! The amount of time he puts into this website and the personal answers he gives to people, esp. pain patients,and the helpful information and advice he provides on Facebook, continue to amaze me.

    You are much beloved my friend and you and Red Lawhern have single-handedly have given HOPE to everyone with pain when everyone else treats us like criminals. When I found your website, I was lifted from despair, depression and tremendous anxiety. THANK YOU AND KEEP FIGHTING FOR US!

    • I agree with you 100% , I talk about Pharmacist Steve to my doctor & nurses that you’d think he was my actual pharmacist. I highly appreciate Steve & value his opinion.

      I’ve been going to the same pharmacy 10+ years consistently with only two different pharmacist that worked their in the 10+ years I’ve been going. 1st one was a guy named Fred and I just loved him, I was sad when he went to another pharmacy, but he was going to get better pay so I completely understand and knew it was the best for him. I was happy for him. He never treated me like a criminal. 2nd pharmacist, my current one Holly, she’s not Fred who I couldn’t replace, but she also doesn’t treat me bad and they all know my husband and I by name. They even know my dog, bc my husband takes him through the drive-thru window & he starts crying like a baby bc my dog knows he’s getting a treat lol my point is I’ve always treated my pharmacy staff with respect, I call them from time to time to get OTC recommendations bc of interactions w/ my husbands or I’s current medication and conditions. They’ve helped me more than I can count. I honestly really respect our family pharmacist and staff! So when reading this I had to comment bc I just don’t understand, I mean I definitely understand when a pharmacist or staff treats you in a bad way, like you’re a drug seeking criminal I can definitely see ppl getting really upset..it’s our lives in their hand when they profile you. I’ve been dealing with having pre-authorization with my pain medication a lot recently for my pain meds 60mg morphine sulfate Er capsules x1 a day that I’ve been on since 2016. I’m a Medicaid in Ohio so it’s been scary, I’ve went without my medication for days and I never get answers, I just get the insurance company blaming my Dr. Office & my Dr. Office blame on my insurance company…and sometimes someone will blame the pharmacy. In October my Dr office finally got me to not have a pre-auth till Feb 2019 , but one problem my authorization team wrote tablet instead of capsule, so they changed it and got an emergency approval for 10days ( this is in December which is confusing) but when my medication ran out in 30days I had to do another pre-auth this month..I got denied! So why was it okay for me to have the tablets? But not the capsules? They told me not enough in the paperwork from my doctors office to say I was still in need of the morphine sulfate Er 60mg x1 a day. So my doctors office said they did write everything ( chart notes ..reasons I’m on pain medication) they needed too. So since I was approved until February for the tablets, my doctor just had my pharmacist fill the morphine sulfate Er 60mg tablets. So here’s the difference, ones a capsule that last 24hours and cost my insurance company over $300 , the tablets last 12 hours and they’re much less. So what I definitely think is a mix of money, someone not doing their job and the new rules for Medicaid and Medicare. I know it’s not my pharmacy. So I’m sure if I’m not the only person getting this done too , I can imagine ppl being a certain way to the pharmacist and staff. If you have a pharmacist that’s treating you well and kind and with compassion you’re lucky and please be kind back even if something bad happened bc your doctor or insurance company.

      Now I’m worried when I got to get my prescription tomorrow that I’m going to have to get another pre-auth bc my doctor put me on the morphine sulfate Er 30mg x2 a day , bc my doctor knows the pain relieving effect will wear off in 12 hours & that I need to take twice daily. I hope that they don’t deny me again. I honestly just don’t know what I’ll do!? It’s scary knowing that your Doctor, pharmacist, insurance company the government can take away your only way living a decent life away from you.

      Again thank you Steve, for all the hard work you do!

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