Friday, July 2, 2010

A Footnote to the Last Post

A couple of comments to the last post made me want to add just a few thoughts. The point I was trying to make (and it's a source of tremendous frustration to pharmacists) is how much time I have to spend some days doing guesswork. I don't mean answering questions or offering advice; I mean trying to get basic information from people whose responsibility it is to provide that information TO ME so I can do my job (and no, I don't think it's the worst job in the world at all). I'm a pretty experienced pharmacist and I can work with some pretty small shreds of information, but there comes a time when I simply can't guess anymore.

There's a subset of otherwise capable people, for example, who will NOT learn the names of their medications. Now, I don't expect them to be able to spell it or even pronounce it that well, but I do expect someone to have a basic idea of the medication's name and what it is for. If you want a written list, please ASK ME. I'd be glad to provide it --- in fact, that IS part of my job, as opposed to the insurance agent/postal clerk/coupon detective/phone operator stuff which is not. I also think people should have an idea of when they need to replenish the supply of that medication (how about when those last few tablets are rattling around in the bottle?) Call the phone number on the label and read me the prescription number. That's it. I will do the rest.

However, if you don't have the bottle you'll need to provide me with a little more information. When I worked in hospital pharmacy we had seriously ill people admitted who had NO CLUE what medications they were taking. Not ONE clue. It was left to someone else (the overworked resident, brand new RN or overwhelmed night pharmacist) to figure out. People who use prescription medication need to know what medication they take. This is not JUST FOR MY CONVENIENCE. IT IS FOR YOUR OWN SAFETY.

And my main point was that we accept this lack of responsibility because it's 'medicine',
it's being sick, it's health care, it's "I'm the patient", it's 'what are they giving me'---- and yet we would laugh at someone who walked into a furniture store and couldn't articulate if they wanted a chair or a coffee table. And the wrong prescription medication has a lot worse consequences.

To the commenter who was frustrated with trying to pick up 6 prescriptions every month ---
I really do sympathize with you. Pharmacy is an over-regulated, very labor intensive business where the human factor takes a front row seat. Most pharmacists I know dislike the 'auto refill' process because it rarely works well for anyone. My advice would be to find a smaller pharmacy with people who will work with you and give you a little more personal assistance. Give them time to work on it and hopefully it will save your sanity.

Thanks for all the great comments!


Anonymous said...


Because I am feeling guilty these days. Awhile back the place where I got primary care went out of business, and before I found a new primary care provider a specialist I see agreed to authorize refills of meds I'd been on for a long time.

I'm running out of refills on those things, so now after I go through the automated refill system I have to phone the pharmacy directly and say things like, "I just called in a bunch of prescriptions, and there are 3 I'm out of refills on. I know Dr P prescribed Prilosec last time, but can you see whether Dr W will authorize refills? And if he doesn't, then I'm just out of luck. .... No, I don't want Dr W to authorize all my refills, just the Prilosec. I'm also out of refills on gabapentin and ondansetron, but Dr P is still the doctor who should prescribe those or not ...."

The whole time I'm thinking what an annoyance I must be, switching scripts back and forth between doctors because I dropped the ball and didn't get a new primary care provider fast enough. And to make it even worse, Dr P is treating me for a chronic condition involving pain, so I'm sure they're checking to make sure that I'm not getting any meds for pain from anyone but her. (I'm not and I wouldn't. I'm not going to jeopardize my access to pain management. But the pharmacist hardly knows that about me.)

All the pharmacists and techs there know my name now, which makes me think they're spending a lot of time on me. As unpleasant as some people must be for you, I'm kind of selfishly glad that there are people who are more labor- (and annoyance-) intensive than I am.

Anonymous said...

I've traveled a lot and I have noticed that the retail pharmacy is a very North American thing and it's flawed.

In most other countries (at least the one's I've visited) pharmacists are considered health care providers and given the same respect as doctors. Pharmacies stand alone, only dispense drugs or other health related items such as face masks, chapstick, vitamins, etc. All pills, including tylenol, are behind the counter. When given a prescription by a doctor, a patient will have it filled in the same way. However, for something that can be taken care of with an over-the-counter medicine, the patient will go in, explain the symptoms and the pharmacist will decide what will work best.

It's not a retail venue, though money is exchanged. It's simply another part of health care.

The retail environment seems to have the effect of making the pharmacist appear as just another sales person. Until I started reading pharmacists blogs, I considered the pharmacist to be another person who sold me a product rather than someone who was a competent health care provider.

I think it would be incredibly beneficial if pharmacists banded together and helped create stand alone pharmacies as the norm. There's no reason for make-up, groceries, office supplies, or cigarettes to be a part of a health care service. We don't find them in doctor's offices, so why a pharmacy? Of course, the problem would getting the box chains on board.

Frantic Pharmacist said...

Anonymous above, I think that is a very accurate observation. In other countries (especially those with single-payer health care) people don't have the mindset to run to the doctor with every minor complaint and do look upon the pharmacist/pharmacy as an actual health care resource. Many have argued that putting pharmacies into grocery & discount retailers was a terrible idea ... not to mention that drive-thru window.

Anonymous said...

I am one of the unlucky pharmacists with the drive-thru windown in a retail box store. My team is excellent in giving personalized professional health care services and I enjoy almost everything about my job. It's always the one or two people a week that drive me nuts by asking for change for a $20 from our drive-thru (when two banks are in the same parking lot) or they ask for groceries or other items not pharmacy-related or the ones who think I'll ring through their milk and coffee faster. Most retail pharmacists have similar stories around here but we're trying to change the perception of what we do.

The Redheaded Pharmacist said...

I am a retail pharmacist that works for a grocery store chain. So at some locations I get both the grocery store experience plus a drive-thru window. Today I spent a lot of my time with patients talking about reward points and our latest transfer prescription promotion. And we also did at least ten transfers after I came in for my afternoon/closing shift half of which were scripts that were originally from us that had been transfered outfor some other coupon.
It is no wonder that the public doesn't see me as a healthcare professional when I sit among isles of crap like makeup and hairspray. And God forbid we actually close the pharmacy for lunch! Good post Frantic. I obviously feel the same way you do.

Mugdha said...

Just found you from the Grumpy Doctor! Having a number of friends just start pharmacy school, I think it's definitely not just something anyone can do. Pharmacists should definitely be shown more respect. Also, I adore your Vitameatavegemin pic.