Norpocalypse

It had the makings of a perfect fairy tale story:

There stood princess Norcoella, her yellow gown flowing in the slight breeze of the crackhead party.  Surrounded by her fellow patrons; crackheads, pushers, dealers, she was on top of the world.  Everyone bowed down to her yellow goodness.  The lied, cheated, faked to get the privilege of holding her hand just for a moment.  The twins, Tylenol #3 and #4 sat there, thumbing the big 3 and 4 on their chests in disgust and depression.  They were once the kings of the party, now pushed aside to this yellow bitch that everyone wanted.

Then on 12:01am on 10/6/2014.  Her party came to a close.  DEA agents stormed the royal  yellow palace, seizing Norcoella and throwing her into the big-boy party.  Demerol, Percocet, Morphine, Fenantyl, Dilaudid, Oxycontin.  She stood there shocked as they all mocked her for the lack of her analgesic potential.  Then, the undisputed king of the C2 party, King Oxycodone the IR himself made her bow before him.  Her crackhead reign suddenly came to a close, and soon, she’ll be forgotten.

On 10/6/2014, the DEA made all hydrocodone-containing products C2.  No more refills, no more phone-ins, no more faxes.  Hard copy (or EPCS e-scripts) only please.  A day known as C-Day, Norpocalypse.  A day where millions of crackheads screamed out in withdraws, and were suddenly silenced.

I have mixed feelings about having Norco go C2.  As I lurk on the various pharmacist forums, other than the billion of “Will I have a job/Whats being a pharmacist like” newb questions that get posted every fucking day, I feel the pain of some of my fellow brethren.

Some stores require all C2’s to be locked in a safe (rather than be inter-dispersed in your inventory).  Others require an RPh to count all C2’s.  Tons of new paperwork, filing, computer changes are dictated by this DEA decision.  Ambiguous laws and interpretations of said laws about existing refills of Norco run rampant.  Nobody really knows what to do for fear of the DEA’s wrath.  Its a mess, a huge fucking mess.

On the other hand, some doctors offices are closing up.  Last week everyone who comes in gets #120 Norco-10, today the office refuses to dispense any Norco.  If you’re an MD and feel that Norco is necessary for your patient to live a normal life, what difference does it make if its a C3 or a C2? Oh, probably because you can’t justify the bucket-load of Norco you shovel at them to get them out of your office.

This will cure one problem though, no more arguing about refills for Norco.  Doctors will be forced to move to ePrescribing C2s via EPCS to prevent their offices from being swarmed by people scrambling to get a hard-copy.  Nothing good can come of this.

I do however see a huge problem with Norco going C2.  That means the street value of Norco will increase since it’ll be harder to scam your MD with some ‘lower back pain’ bullshit story to get a handful of them.  Doctors don’t want to be under the gun from the DEA for writing C2’s.  You can guess what happens then.

10/06/2014 – C3 Norco, we shall never forget.  Save an empty stock bottle folks to reflect on a time where Norco paved your angst like a yellow brick road.

October 6th, 2014 by theangrypharmacist | 19 Comments »

Purpocylpse

I cant believe I’m writing this.  The news is so shocking that my brain cant wrap around exactly how this could be.  I mean, part of me wants to do cartwheels, and another part of me just wants to sit and sob.  Its like I came home to find my wife making out with another hot chick and asked me to join while throwing me a huge dildo.   Shit I’m getting blue balls just typing that.

Hold on to your hats because……………

ACTAVIS IS NO LONGER MAKING PROMETHAZINE WITH CODEINE!

IM NOT FUCKING KIDDING YOU! THE INFAMOUS PURPLE DRANK IS FUCKING DEAD!

Dont believe me? Check your ordering system.  Amerisource has no listing.  McKesson has MANUFACTURER DISCONTINUED.  One of my sources reported that someone called Actavis and they stated that they have just decided to stop making promethazine with codeine.tumblr_mklix14Yc81rrotfzo1_500

No longer will we be getting “do ya carry da actavis?” calls.  No more bitching from the crackheads that the QT or Hi-Tech brand “Dont work” or “I be allergic to dat shit”.  No longer can people say “I can only take Actavis” because you know what, they can take a bunch of fucking nothing now.

Prometh with Codeine will no longer taste like ghettofab syrupy purple, it will taste like how all cough syrups should taste, like goat anus.  They aren’t meant to fucking mix with Sprite and enjoyed after a long night of fucking your bitches and collecting taxpayer-funded benefits; they are meant to be choked down because you’ll do anything to get rid of that fucking cough.  Wait, did I imply that ‘da Actavis’ WASN’T used for legit medical reasons?  Well unless theres an ICD9 code for “My life sucks and want to get high”; then yes, I did imply that.  If you want to get fucked up on cough syrup, deal with the aftertaste of pennies and last nights digested dinner in your mouth you fucking crackheads.

This is fucking great.  Hats off to Actavis for actually realizing that their name was synonymous for “Abuse and Diversion” like Kleenex is to facial-tissues. If Watson stops making the DAN Somas, I think I just might die.

Now if we can only get QT to take the yellow out of the Norco 10.

February 26th, 2014 by theangrypharmacist | 36 Comments »

Paying the PBM’s to service them.

So I had this nice 2014 post queued up that involved:

  • Me shutting down the site and hanging it up.
  • Me meeting this awesome hospital pharmy named Michelle who has (of all else) a totally awesome cooking website that (used to) throw down f-bombs worse than yours truly AND wrote a kick-ass cook-book (plus she was all “OMFG FAMOUS PHARMACIST” when she met me).  Every fucking pharmacist is published but me.  At least hers involves food porn and fucking tons of delicious bacon.  Uh.. Fucking as in the adjective, not the verb of her having sex with bacon.  Sorry NomNom, didn’t mean to imply that you have sex with bacon.  Fucking bacon is delicious though.. ARG FUCKING AS AN ADJECTIVE GOD DAMMIT.  You get the picture.  Her website is http://www.nomnompaleo.com and go buy her book, its awesome.  Her little cartoon of herself has no nose, which sorta bugs me, but I will certify, under penalty of perjury, that in real life she DOES have a nose.
  • Me getting pissed off at this derpy douchebag patient and reviving the smoldering blaze of TAP that lives in my soul.  No, really.  I almost brained this fucker with the cash register I was so fucking pissed off at his utter waste of a life, and a resulting waste of my time.  Then his mother got all involved.  He is 40 by the way, that should speak enough right there.
  • How in the past few years, I have taken into consideration not offending anyone (ie: Crackheads) with my ranting, and by doing so I am doing you all a grave injustice.
  • How gasoline cans in California fucking suck with the safety valve (instead of a direct spout) and as a result you spill more gas on the ground (and all over yourself) then you get in the tank, thereby making the “save the world” mentality that California wants to impose on people a fucking waste of effort, not to mention a huge safety hazard.  Plus you smell like fucking gasoline for a few days and must resist the urge to light yourself on fire to end it all.
  • Other shit that Im too lazy to type because Im fucking livid about the topic below.

However, this topic came up and is far more important (and involves far more swear words).

We all know that drugs are like stocks, the price goes up and down (mostly up).  However recently, a ton of shit has just skyrocketed in price.  Take various creams.  They used to cost 10 bucks a few months ago, and now they are just shy of 100.  Digoxin ranges from 900-1000 dollars for a bottle of 1000 where a few months ago it was 50 bucks for 1000.  Morphine ER has jumped from pennies to fucking hundreds and Endocet is almost 100 bucks a bottle.  Nobody knows why the price is going through the roof, and nobody has any answers other than the generic drug manufacturers must enjoy raping the American public so they can sell their shit in Mexico for reasonable prices.

Now usually this isn’t a problem, because as the price of the drugs go up, the PBMs (The companies that YOUR insurance companies hire to do the processing/computer shit and pay US, the pharmacies) adjust their prices and pay us more.  Its done on a contract basis like Cost + shit + a crap fee.  Its not the greatest, but it keeps the doors open and paychecks from bouncing.

HOWEVER, due to some fuckery or just plain greed, as the price of medications go up, they PBM’s are paying based upon the OLD price.  That means that little ms crackhead who gets Morphine ER that now costs me $200 the store is getting a fat check for $40, the price of the drug from 5 months ago.  In other words; under cost.  Thats right, I’m expected to dispense medications and take a $160 dollar loss.  Then the fucking twat has the balls to bitch about her $3 copay and take up 20 mins of my time as she bitches about what she can take (for FREE) because her turds resemble a fucking piece of plaster-of-paris.

So whats a pharmacy to do?  Take care of the patient so they don’t die and take a $100+ loss? Or tell her to take her shit elsewhere? The choice is easy, give her back the Rx, tell her it pays under cost, and you dont know where she can go to get it filled.  Per your contract with her insurance company she can’t pay cash (HAHAH PAY CASH!! AS IF!!).  Only rich fuckers and chumps pay for their medications now days.  Its not called Freemacy for nothing.

There are two huge points to be made about this:

  • Unless I can pay my fucking house payment and put food on the table using “Good Deeds” as a currency, Im not going to take a loss filling a prescription.  That little lady, when push comes to shove, doesn’t really give two dicks about you, your kids, your store, or the good deeds you do for her.  She wants her fucking dope, plain and simple, and she doesn’t want to pay for it.  By you taking that loss, you have just shown her that your time/profession/skills are worth nothing to her.  In fact, you’re just a fucking whore to her and her insurance who takes a fucking and then gives $100 for the privilege of getting your asshole reamed out.  Its reverse prostitution, and we as a profession are better than that.  Well, I used to think better than that, until the chains started handing out gift cards to PITA patients instead of backing up their abused staff and showing these fucks the door.  Grow a fucking pair chains!
  • By refusing to fill the Rx based on losing money, you are putting the ball in her court.  The insurance companies dont give a fuck about the pharmacies, but they give a fuck when she gets on the phone and cries that nobody will fill her medication.  SHE pays their paychecks, not us.  A problem with HER insurance reimbursing is not OUR problem, its HERS.  Does the grocery store give a fuck that your credit card was stolen by hackers who got into the Target systems and thereby wont work? No, because its YOUR credit card through YOUR bank so its YOUR responsibility to take care of that shit.  If enough patients complain and whine then maybe they will do something about it.  Yeah, and I can pull gold out of my asshole.

Now this all sounds fine and good, however the chain stores (and the pharmacists who staff them) really don’t give a shit if they lose money on an Rx.  They hand out gift cards to whiny fucks who complain that their prescriptions weren’t fill in 2 seconds or less.  The chains are so afraid of losing business they will gladly take that loss with a smile on their face.  The chain stores are killing the profession of pharmacy.  By having the chains put up with this bullshit, they are just showing the PBM’s that we are nothing but fucking whores who’s time and education are worth absolutely nothing (because we will fill the Rx even if we lose money on it AND reward patients for abusive behavior).

I’ll just make another point, that the PBMs, the insurance companies that hire them, and the pharmacists who work for these companies are nothing but fucking idiots.  They are so blind to the big picture, that they have NO CLUE that independent pharmacies are the counterweight to a huge big deep dicking thats on the horizon.  Let me elaborate:

You cut your reimbursement so much that it drives all the other pharmacies out of business.  Sure you make a zillion dollars and your CEO can afford that beach-house.  Sure you traitors to the profession get that fat bonus for saving “all this money” and the CEO strokes your cock a bit for being a “good little insurance-company pharmacist” for saving their plan a ton of cash with your bullshit cost-analysis and P&T handjobs.  However now all there is left are Walgreens, CVS, and Rite-Aid.  Three huge companies that will gladly pay that million dollar anti-trust lawsuit fine for the sole ability to COMPLETELY FUCK OVER YOUR INSURANCE PLAN AND RUIN YOUR PBM.  How?  Easy.  The men in suits from Walgreens come to your insurance company and want to talk about their contract:

“So, since there are no independents left, we want to renegotiate our contract.  We want cost + 25% + $15 for EVERYTHING.  Oh? You don’t like that? Well then I guess you’re going to lose a few hundred stores in your network.  Oh, and see CVS and Rite-Aid? They want the same deal that we want.  Man, its going to suck for you when the members who use your plan cant go ANYWHERE ELSE to fill their prescriptions because your shit reimbursement rates put the independents all out of business.  Why don’t you think about that for a few hours while we go to lunch with the CVS and Rite-Aid execs and discuss if your plan fits within our business model.  Oh, and we don’t care if you sue us for anti-trust, because we’ll make up that fine in a month from this revised contract.  Im sure that your members will understand.  Chao!”

You have painted yourself in a corner with only a few HUGE chains left.  Huge chains with a TON of stores that your members are forced to go to because there are nobody left.  Your penny pinching now cost you your anal-hymen.  It fucking kills me how people shop at Walmart because they have done the exact same thing to the manufacturers of household items because there are no little mom and pop shops around anymore to offer any competition.  They can name their own price, and that price is a few steps up from FREE.

So when you fill that Rx and see the fat negative reimbursement and your pharmacy system blows up with warnings that you’re losing your ass; think of me.  Think of where you are going to work when the toilet of pharmacy finally flushes and we’re all out of a job.  I’ll see you fuckers in the unemployment line with a huge smile on my face and a huge bowl of “I FUCKING TOLD YOU SO” for you to eat.

January 8th, 2014 by theangrypharmacist | 63 Comments »

Im dreaming of a Crackhead Christmas.

I hate the holidays.

There, I said it.  We should take the Christ out of Christmas and throw in Crack.  Call it Crackmas from here on out, because that is the kind of shit myself and other retail pharmacists need to deal with on a daily basis this time of the year.  Soma and Norco are the reason for the season, and when you can’t take your fucking life or family any more, you need your pills.

The holidays, to me, are a really shitty time of the year.  Let me sing you the song of my people and whine about why I wish tomorrow was Valentines day.

  • Christmas started well before Thanksgiving this year.  My co-workers, full of holiday fucking cheer, demanded we put on the 24/7 Xmas radio station for the “holiday season”.  I’ve been listening to “holiday music” for 9 hours a day, 5 (sometimes 6) days a week, SINCE THANKSGIVING.  I’m no longer dreaming of a White Christmas; I’m dreaming of a hot-tub, some fentanyl patches, some cocaine, some Viagra, and a bunch of fucking Thai hookers.  I’m dreaming of tossing that fucking radio into a wood-chipper and doing a fucking victory dance as the parts rain down on my head (knowing my luck the speaker magnet would crack my skull).  I’m dreaming of an ice-cold bottle of vodka and Simply Orange (no pulp) sitting in front of a roaring fire.  I have grown to hate the 5 fucking Xmas songs that are remixed 100 times each and played on a gigantic fucking loop.  Grandma got ran over by a reindeer because she put on Xmas music before Thanksgiving, thats why.  Bitch had it coming.
  • It gets dark early here, and for those of us who work behind the counter (and have access to the narcotic safe) that means it gets really scary once the sun goes down.  You see, there are 2 ways to get a prescription medication filled in this country.  With a prescription, or with a gun.  Unfortunately, with the GunRx ™ there’s no quantity limit, no refill limit, everything is covered with 0 copay, and you get to self-serve.  Most of the Indy’s (and a few of the chains) have already been hit in the last few months.  Fortunately nobody has been hurt, only nerves rattled and holidays shattered by having a gun shoved in their face for a handful of narcotics.  People want money this time of year, and oxycodone makes good stocking stuffers.  Keep your local Pharmacist in your thoughts when it gets dark, because for some of us, we put our personal safety on the line to make ourselves accessible.
  • On a lighter note; when it gets cold here, people (read: old people) decide that since they don’t sweat, they don’t need to shower.  The smells range from cat-piss (because cat’s aren’t going to fucking piss outside in the cold, fuck that!) to what resembles like an onion wrapped in gauze and baking in the cavity of a chicken that’s been sitting in a car for about 2 months.  I have no fucking idea what twisted part of my brain that description came from; but I must say, I’m pretty proud.  People just don’t fucking shower, and its ALWAYS the little old confused lady with the dull cow-eyes who has to ask for the 10th month in a row what her hydrochlorothiazide is for.  Ignore the simple fact she has been taking this since it was brand-name only.  At this point you pull rank and make the new pharmacists go, or better yet send an Intern so they can have a “learning experience”.
  • People, as a whole, have their asshole-dial set to 11 this time of the year.  Yes, I get you are stressed from all that christmas shopping.  However don’t complain that I am taking too long to fill your 20 Rxs (that you need RIGHT NOW) as you bitch to the crackhead next to you about waiting in front of Walmart 5 hours before they open so you can get $10 off a fucking TV.  Then have the fucking balls to whine at me about why your copays are so high because you’re in the Medicare coverage gap.  Everyone in retail is busy this time of year, I get it.  Be part of the solution and shut your fucking face and stop being part of the problem.  Usually these assholes get the price of their Soma raised.  Merry fucking Xmas.
  • Staffing can be a real issue this time of year.  My coworkers deserve days off to be with their families (or take trips).  Hell, they work with me for a living, they deserve a fucking medal and a parade once a year.  This leads to short-staffing, which means the gaps need to be filled.  This really isn’t a whine, just an observation, because I will gladly be a clerk for a day (or even come in on my day off) to give a hard-working employee some much needed time off with their family during the holidays (awwww).
  • However, I am NOT a fan of stupid game shit like Secret Santa.  Every fucking year we all draw names to play this stupid fucking game that just drips awkwardness and poor gift selection.  This year the queen of festivities (ie: my tech) decided that we shall have no gift cards, and everyone needs to write what they want on a fucking secret santa list.  My exact words to her were “What the fuck, why do you hate me and my fellow male coworkers, fuck this noise!”.   THEN I was forced to write what I wanted.  Well fuck, guess putting down “blowjobs” would be a bit out of line, so I left it blank.  Then the smart-asses come out of the woodwork and put down “A life”, “A personality”, “A sense of humor” next to my name.  When I am eventually forced to write something, I put something really vague down so someone asks me about it.  That person, in 100% of the cases, drew me for secret santa.

Sitting here in my half-drunk state writing this, I can think of some reasons why I put up with this shit.  It’s the little old ladies who come in just to bring you a Xmas card thanking you for all you did for them.  It’s for the families who drop off a box of candy, or make you cookies.  It’s the kids who made you something at school saying “thanks for making me better”.  It’s the smiles and the thank-you and the Merry Christmas that make all the above seem sorta pointless and petty (except Secret fucking Santa, I fucking loathe that game).

So from my cold bitter angry heart to yours, I wish you the merriest of Crackmas and fuck Secret Santa.

December 20th, 2013 by theangrypharmacist | 19 Comments »

SOMABOTS, TRANSFORM!

So enough with the serious posts about the idiots of the world.  This one is going to give you the knowledge to impress your friends, and frighten your enemies.  In fact, this information might get you laid!

Full disclosure: I did only enough research as look on Wikipedia.  Seriously, I was looking up what the half-life of Soma was (since my Lexi was on the shelf and I didn’t have the ambition to flip through it) and I found this information out.  Laziness provides you with yet more entertainment!

Oh, and before one of you crackheads nitpicks me for this, I use the brand names throughout this post.  Yes, I know that the only dispensed **Soma** out there is that stupid-as-shit 250 mg crap out there (which if you stock, you are a fucking tool).

We all know the drug Soma (or its generic name Carisoprodol).  We get calls about it, we get bothered about it, some of you may even be on it! (No, you can’t get an early refill).  But how much do you actually know about it?

Soma was intended as an antiseptic.  A superior antiseptic!  No bullshit!  I guess if you consider the people who are hooked on this stuff have killed all the neurons that product truthful statements, personal hygiene, common sense, month supply calculations and other socially acceptable behavior then maybe the drug did work at intended.

So it came out instead as a muscle relaxant.  For all of those chemistry nerds, I present to you two images for your consideration.

800px-Meprobamate.svg

 

 

 

 

One of these is Soma.  The drug we all know and love.  The other is a drug called Meprobamate also known as Miltown/Equanil for those of you who are close to retiring.  See a similarity?  Are you old guys out there chuckling?  (hint: Soma is on the left).

The funny thing about Miltown (other than having a stupid name) is that its a tranquilizer, and is no longer used in the United States because the benefits do not outweigh the risk.  It is considered addictive at doses not higher than therapeutic.  Gee, does this sound familiar?

Soma was a chemical modification of Meprobamate to make it better, less potential for abuse, and thereby less risk of overdose…… Where have we heard this before?  Oh wait…  Heroin!

Soma just -recently- became a controlled substance (January 2012).  Miltown has been a controlled substance since 1967.  Most countries other than the good old ‘Merica has banned or severely restricted the use of Soma due to its potentiating effects with the narcotics, alcohol, and other fun shit leading to shitty dancing, unwanted babies, pharmacist alcohol abuse, and sometimes (but not NEARLY ENOUGH) death.

Are you slapping your head yet and wonder what the fuck is wrong with this picture?  Let me spell it out for you.

Soma converts (probably a good chunk) into Miltown in the body.  Miltown has been a controlled substance since the 60’s due to abuse, and Soma JUST FUCKING RECENTLY (sorta) became a controlled substance.  Now I’m only a stupid pharmacist, but didn’t someone at the FDA and DEA a long fucking time ago look at these two chemical structures and say; “Gee, MAYBE we should make this a controlled substance right off the bat since that fucking isopropyl group on the end will just get whacked right off in the body and make Miltown.. A CONTROLLED SUBSTANCE!”  Am I the first person on the planet to fucking realize this?

 

October 25th, 2013 by theangrypharmacist | 32 Comments »

A pharmacist example for non-pharmacists.

Holy shit, its almost been a year.

No, Im not dead.  Just took a small vacation from the site.  Family, work, etc.  It happens.

Ive been going through the (years worth) of comments posted to this site, and from what I can see, they seem to follow a common trend:

  1. Im an asshole, and all pharmacists are assholes.  All of them, but when its time to refill your Norco they are your savior and best friend.
  2. Fibromyalgia is real, I’m an asshole for thinking otherwise.  Santa is also real.  Ever notice how spell-checkers always get hung up on fibromyalgia like its a word that doesn’t exist?  Interesting. (OH COME ON, LET ME POKE SOME FUN)
  3. Tell me your entire life story to justify your usage of pain pills to try to convince yourself that you’re not a crackhead.  If you don’t think you are a crackhead, then you probably aren’t. Convincing the internet with some 10 page paper on how you got hurt, and SSI denied you, and you’re on ALL THESE MEDICATIONS and the mean pharmacist wont refill them early because your crackhead kid’s friend “stole them”, blah blah blah isn’t going to help your issue.

That pretty much sums it up.  Im sad for humanity.

On a lighter note, I want to put something into perspective for those non-pharmacists out there who think we just stand there, drink coffee, and deny your pain pills while laughing manically.  Just bare with me.

Imagine you own a small cell-phone dealership.  You carry all sorts of cell-phones, from the latest Android, to the iPhone, to the big bricks in the bag from back when we all had mullets.  So many fucking cell phones people come in and go “holy fuck! you have a lot of cell phones”.  You also have a big button to make them all ring at once just because you are that much of a badass.  Is your dick hard from cell-phone envy? Mine is; I’m typing this one handed actually.

Anyway, a customer comes in with a letter from T-Mobile.  The letter says “Dear badass cell-phone dealer, please allow my member to purchase ONE iPHONE”.  You happily take the letter, and give your customer a shiny new iPhone.  Your customer is so fucking happy because his baby-momma keeps on calling, and his old phone just isn’t working as well as it should be.  You go to the cash register;

“That’ll be $200 for the phone please” you ask with a smile.

“What the fuck! I don’t have any money! This is supposed to be free! I have a VISA card” the customer yells rudely like you insulted his mother

“Okay, do you have the card so I can process it through VISA?” you respond.

“No.  Call up VISA and get the number for me” as the crackhe..er..customer caresses his new iFre..er..iPhone.

Let me pause the exercise right here.  Would you, as a customer who goes ANYWHERE make the store clerk/cashier/etc CALL YOUR CREDIT CARD COMPANY for your credit card number?  Am I the only one who thinks if you asked this you would be laughed all the way out the front door?  No? Good.  Lets continue.

After 20 mins, you finally get the VISA number of your BELOVED customer.  You punch it into your little device and an error spits out:

“TRANSACTION DENIED, VISA CUSTOMER MUST USE ANDROID PHONE”

Oh shit, looks like Google is fucking Visa.  You gingerly tell the customer that his card will not pay for his nice iPhone because his credit card company wants him to use an Android phone.

“WHAT THE FUCK DO YOU MEAN! T-MOBILE SAID I NEED AN iPHONE!”

You kindly explain that if he wants an iPhone, that he would either have to pay for it, or you can contact T-Mobile to see which Android phone would be the best fit for you so Visa will cover the cost.

The customer throws the iPhone at you, and storms out mumbling that the cell-phone shop down the street will get him his iPhone.  You restock the iPhone and proceed to repeat this same conversation about 4 times before you get to go home.

So the story ends.  That customer was a dick right? I mean it wasn’t the pharmaci..er..cell store owner’s fault that his insur-….credit card company didnt cover his iPho..damn…medications!  I mean what kind of asshole would blow up at someone who is doing their best to help them out?

One word answers this question: EVERYONE.  EVERY-FUCKING-SINGLE-ONE.  Welcome to retail pharmacy, here is your tough skin and alcohol habit.

It sucks to get yelled at, and it sucks even more when you are getting yelled at over something that is 100% out of your control.  If you are one of those “Oh, well they make 100k a year to get yelled at” idiots go fuck yourself.  Any decent human-fucking-being with a soul doesn’t like to be yelled at day in and day out while doing their job of helping people.  Especially when you are getting yelled at while you are trying to HELP them.  The money is there for our knowledge to keep you from doing something stupid and dying, not to be your own personal fucking punching bag.

Its good to be back bitches.

September 10th, 2013 by theangrypharmacist | 78 Comments »

Trying to not kill your patients.

Yeah yeah, I havent been posting.  Lets get the fuck over that and go into how I almost ended a patient’s life today with nothing more than a counting tray, and a glass pint bottle of prometh with codeine (dont even start to tell me you haven’t thought of doing it).

There is a little known fact that when you, the patient, call in your prescription numbers we usually get started on filling them.  Oh, by ‘little known fact’ I really mean common fucking sense.

So when you, the patient, call in 10 rx numbers, you can probably safely assume that we are going to start filling them.  We are going to fill them with staff that the store pays for to fill prescriptions.  The store gets to pay for their employees with money gained from filling your prescriptions.  Again, I realize this is fucking rocket science to some people, but to the majority of the non-paste eaters out there this is as surprising as not-winning when you play the Lotto.

Therefore, when you the patient come in to pick up your 10 rx’s (which if you didnt think they would be filled why the fuck would you come in), and decide to tell ME (of all people) “Oh, well these are a bit expensive can you transfer them to Walmart”  why in the fuck would you would be shocked when I say “No”.  I mean its not like you paid THE EXACT SAME FUCKING COPAYS LAST MONTH.  So this month copays shouldn’t be any surprise you dim-witted sack of shit.  Did the medication-fairy magically make the drugs free? Did we have a bumper crop on the Soma tree so we’re just giving it away now?  Fucking shit I was two seconds away from taking those drug bottles and shoving them up their ass sideways.

Not only that, you have the nerve to glare at me when I say “You know, its pretty rude when you called all these in, we spent all this time filling these, and now you want them to be transferred to a Walmart.  Its like ordering food at a place then sending it back once it gets put on the table saying ‘I’m going to another restaurant because their steak is cheaper’.”  I realize that the concept of analogy is hard to understand with your two brain cells, but the point I’m trying to get through your thick skull is that its a pretty dickish mood to have me do all this work to undo it an hour later.  I don’t give a fuck about your “limited income” excuse that you throw around to get what you want.  Being on a limited income isn’t a license to be a fucking twat and waste the stores “limited income” and my time when I could be helping patients who actually have their shit together.

FUCK.  I feel better now.  Really, no bullshit, I really do feel better.

So to answer the question you all may be asking; yes, I did transfer the prescription.  However I called Walmart and warned them about this dillhole’s antics.  The pharmacist said “Oh I absolutely hate it when they do that, i’ll make them stand here before we even think about starting them.”  Problem solved.  Although pharmacy as a whole is going down the shitter, I’m glad that us, as Pharmacists, are willing to stand up and get even on behalf of each other, especially for uncalled for bullshit like this.

 

September 20th, 2012 by theangrypharmacist | 110 Comments »

An open letter to my patients.

Dear patient standing in front of me.

Yes, I mean you.  You standing at the counter eye-fucking my forehead.  Listen, I’m sorry its taking so long to fill your prescription.  I mean you’ve been standing there for a whopping 5 mins not including the time it took my girls to verify that all of the information is correct in our computer system.  I’m very sorry that its taking so long to bill your insurance, be it that you left your card at home a whole 5 min drive away and refuse to get it.  I really wish I could make your day happier, but regrettably I can’t stay in business if I dispense $400 worth of medication to you without some sort of guarantee of payment, and I can probably safely guess that your credit-card won’t be able to take that hit (if you even brought it with you).  Yeah, I hear your sighing as if its some huge inconvenience we are putting you through by actually making sure we get paid for this drug, not to mention checking to see if they will actually kill you or not.  Whats your rush? The 5 other patients that you managed to cut in front of don’t act the way that you do.  In fact, I’m sure your actions have brightened their day as much as you have brightened mine.

I really wish you could see it from my perspective, getting paid $5 over the cost of the medication only to be screamed at because you don’t feel you should have to pay your share of the cost that equates to about a 97% discount for you.  I wish you could see yourself acting like a spoiled child who didn’t get brand name frosted flakes because your mother is on a tight budget.  In fact, I wish your mother slapped some manners and common courtesy into you growing up.

When you snatch that bag out of my clerks hands and storm off like we just pissed in your cornflakes it sucks, not for you but for us.  We work hard to help you, and to be quite honest, we can only do the best we can with what we are given.  In your case you gave us nothing to work on, no information, no help.  Im sorry my crystal ball isn’t working properly today so your prescription took a bit longer than expected.  Your attitude ruined our day, because we have that feeling that we could have done something different to make you less angry, like rub your feet or give you a lapdance.

So I’m sorry patient who is screeching his tires as you leave the parking lot in anger, Im sorry we took so long to fill your prescription.  I hope we can do it better next time.

Oh, and go fuck yourself you worthless sack of shit.

Sincerely,

Your Pharmacist.

May 25th, 2012 by theangrypharmacist | 97 Comments »

The FDA obviously hates the public and needs to lay off the crack pipe.

Submitted by a shitpot full of people, the FDA has gotten this wonderful idea to allow people (read: idiots) to buy Rx prescriptions OTC using a kiosk rather than a Doctor to issue the Rx.

http://www.washingtontimes.com/news/2012/apr/29/fda-may-let-patients-buy-drugs-without-prescriptio/?page=all

The jist of the article (for those too lazy to read it), is that you would go to a kiosk, and via a handy flow chart be able to obtain an Rx for antibiotics (!!) hypertension medication, cholestrol medicine, etc without seeing a doctor.  Your helpful pharmacist would help you from then on out.  Yeah, as if that’s going to magically make you become more compliant.  I’ll get right on that after my job as the vicodin-police, insurance agent, and your personal fucking nanny are done.

Lets take a journal into sarcastic TAP-land:

I think this is a completely fucking great idea!  We all know that Rx medications are completely safe, require no professional monitoring, and can cause no harm to the patient.  I mean who in the fuck cares if your potassium goes through the roof when you’re on an ACE-I, or if you get rhabo while on that statin.  This whole Rx concept is obviously a cartel plot by the medical industry to milk you out of copay money to line the pockets of BMW driving doctors as they light their cigars with your crisp $100 bills gotten from your copays.  Its not like those doctors know any more than the crackhead off the street…..

Shit, this whole idea of people just making shit up at kiosks to get a truckload of antibiotics is such a good idea!  We all know that antibiotic resistance is just a big fucking lie made up by the pharmaceutical industry so they can push their ‘newer’ expensive antibiotics to leech the consumer dry.  In fact, all of medicine is a big fucking lie meant to milk you out of your hard earned cash.  See this MD/PharmD degree? Thats just made up letters that we got from a mail-order school.

Travelling back to real-life common-sense land:

This whole clusterfuck was meant to save the patient money they would have spent seeing a doctor.  Because thats SO MUCH FUCKING LESS than say a hospital admit because your potassium shot up to 12, your kidneys stopped working because you have renal issues and had to get that ACE-I, or because MRSA is eating your face off.  Not to mention the tons of other issues that come with taking A CONTROLLED FUCKING POISON that externally influences certain enzymes and receptors in your body thereby circumventing your body’s own natural regulation pathways.  Oh shit, you didn’t know that most (if not all) drugs did that? Actually I’m sure you probably thought medications were made from unicorn farts that magically made you better.

Here is a fucking great idea, why don’t you use your doctor to DIAGNOSE whats wrong with you, and have the pharmacist PICK OUT THE RIGHT MEDICATION.   I mean we all know that 90% of our time is just faxing the doctor for a drug change because its the insurance company, not your doctor who decides what drug you get.  Tell us whats wrong with you, any lab values that we might find useful, and let US pick out the most effective and affordable drug.  Pharmacists are immune to the drug-rep masturbation, we (for the most part) know our shit, and our ass is on the line with you by default if the shit goes south.  The hard cold fact is that MD’s are good at figuring out whats wrong with you, and WE are good at what drugs to use.  Same coin? Different side? Sound familiar?  Obviously not to the FDA.

If the APhA is all about this, its just more evidence that they are focused at planting new pharmacy trees while the retail pharmacist forest behind them is burning to the ground.  Why are they always ignoring what needs to be fixed in lieu of added work for no added money for us?

Oh, and if you are thinking “Well it works in Mexico”, take a second and think about what happens if you take something and die in Mexico.  Do you get to sue someone? Do you get compensation from the manufacturers? Nope, you get a dirt-nap and a “Oh thats too bad”.

But really, what the fuck do I know.  I just count by 5’s all day while watching Dr Oz and drinking coffee.

May 5th, 2012 by theangrypharmacist | 75 Comments »

How to make your pharmacy career less painful.

Some asshole who shall remain nameless was giving me shit about my lack of posts (man, get a book published and you somehow think you’re God or something), so heres another gem for you all.

I recently had the pleasure(?) of spending some quality time with a bunch of pre-pharmacy and pharmacy school students a few weeks ago.  Since they all look up to me like I’m the Asian Jesus, I decided to be an excellent role model for them all (in typical TAP fashion, although they dont know I’m TAP)…….

I told them how retail pharmacy really is.  No candy coating, no bullshit MTM verbal masturbation sessions, no smoke-up-ass like *PhA loves to throw at them.  Just both barrels right to their faces about exactly what life is like in the trenches.  For those who didn’t cry or decide that it wasn’t worth it, I offered them gems of whiz-dumb having both gone through what they are going through now (school) and the transition into being an adult with bills, responsibilities, and a full time job.

One of these topics was how to handle pharmacy-related stress.  I swear I should teach a fucking class on this, but I doubt any school would allow some asshole who shall remain nameless and I to wheel in a pony keg and a few cases of scotch into the classroom.

For those of you at home who think being a pharmacist isn’t stressful, go into your local retail pharmacy at opening and closing on Monday and Friday.  Notice the scramble running around in the back?  Thats a pharmacist about to flip his shit.  The public thinks we just count by 5’s and drink coffee all day.  Well, I cant blame them, because thats how we’re portrayed in those shitty Target commercials:

Lets examine a few (oh boy).

**UPDATE** Someone (ahem) made these videos private.  Whoops!

Okay, so the glaring obvious errors with that commercial is that…. Its all fucking made up.  Whoever made that commercial obviously has not worked in a pharmacy, went to pharmacy school, or has waited in line in a pharmacy.  Lets show that kid fucking crying in her book hating her life as shes studying for that kinetics final.  Lets show her graduate working graveyard (because the market is hosed) with some crackhead giving her both barrels about their fucking soma being too early.  “I am a medical dictionary” turns into “I’m a fucking narcotic dispenser”.  Oh, and who’s going to pay for “Flu shots for all”?  For all of those retail pharmacists out there, when was the last time you got to whip out a word larger than “Not Covered”, “Copay”, “Too Early”, “Doctor hasn’t faxed back yet” or “Yeah, we have the yellow Norco”?  Yeah, thats what I thought, medical dictionary my fucking ass.

**UPDATE** There was an awesome “sneeze whisperer” youtube video here, but someone got butthurt and made them all private.

I hate to break it to you all, but allergies isn’t fucking rocket science.  This commercial makes the public think that allergies are some complex thing that you need a PharmD to treat.  Take some fucking claritin/allegra/zyrtec and GTFO.  No, your insurance won’t cover that, but my foot will assist you in your travels.

A few coworkers saw this bullshit and we came up with a better version (that I’m allowed to make parts public).

“I am in Rho Chi”

“I took the State Boards 3 times”

“I have an internet girlfriend”

“Nobody knew who I was in school”

“The tampons are on isle 4 next to the maxi pads”

“I am a raging alcoholic”

“I masturbate to 2-girls-1-cup”

“I asked stupid questions in class so my classmates knew I still existed”  (You fucking know exactly what im talking about, dont you?)

You get the idea.

The fact is that unless you’re doing under 20 Rx’s a day, real life pharmacy isn’t that laid back and awesome.  The only place I have time to ponder life like that is when I’m taking a shit, and even then I’m trying to birth it out as quickly as possible because I have 3 lines on hold, a little old lady who wants to ask me the same question she asked me last week about her Aricept, a crackhead who wants a price on 460 oxycodone 5mg from an out of town doctor, and my tech decides that now would be a good time to pick up her kid from school.  Hows that for a fucking Target pharmacist commercial”

“Im too fucking busy for this shit, get that fucking camera out of my face, SOMEONE GET LINE 2!!! JUST GET A FUCKING MESSAGE HE JUST WANTS TO GIVE ME HIS RX NUMBERS! What did I say about that fucking camera!  Fine, IM A TARGET FUCKACIST, I SAY GET THE FUCK OUT”

Now that I’ve gotten some random rage out of the way.  Time for the vicodin and soma of this little rant.  How to deal with stress from pharmacy and how to tolerate your life in retail pharmacy.

  1. Alcohol doesn’t solve your problems.  Ironic that I’m writing that as I swig out of the bottle some shitty wine that a patient brought in for us for doing something that I really dont remember, but somehow he thought I was the shit.  Don’t turn to booze to solve your issues.  If you do, you might get a pharmacy book published, be part of the cool kids club on twitter that has more followers than our national association, and get to use 4 letter words on the internet and people love you for it.  Honestly, in all seriousness, all joking aside, this wine really fucking sucks.  Oh well, its getting this post made isn’t it!  Oh, yeah, don’t drink to solve your problems.  Its a short term patch for 30+ years of fucking hel-OH HAI WINE!
  2. Only vent to people who understand.  You went to school, you made friends (unless you’re a Target Pharmacist!).  Hell, you probably even joined an awesome pharmacy fraternity where you became a ‘leader in pharmacy’.  Those are the people who you want to vent to.  Avoid venting about work to non-pharmacy folks.  They will think you HATE your job.  Unless they work in a pharmacy, they don’t understand the stress and pressure of working in one, let alone being the person who’s license is riding on everything.  If all else fails, write out the anger, it worked for me.
  3. You are just as important as the lowest paid person who you employ.  This sounds sorta funny, but if you walk around wielding your PharmD like its the holy grail and make people call you Dr, your life is going to suck.  Your techs and your clerks are your work-family.  Unless you want to be counting out everything, ringing up people yourself, and screening all your own phone-calls yourself, treat them with respect and kindness.  Trust me, being high-and-mighty will just put your nuts in the vise when the shit hits the fan.  A good time to pull out the PharmD card, is when some douchebag patient is giving your clerk both barrels over their own fuck-up. Use your authority on the patients when they get uppity, not on your staff.
  4. Get a hobby that has NOTHING to do with pharmacy, medicine, the store, etc.  Collect stamps, work on cars, do SOMETHING other than come home and stew about work.  Your family, your marriage, and your sanity will love you for it.
  5. Leave work at work, and home at home.  This is harder than it sounds, but being in a shitty mood when you get home everyday is just going to be the turd in the family punch bowl.  A lot of people learn this the hard way.  Don’t blow up at your family (or kick your dog) over what happened at work.  On the same token, if your kid really pissed you off, don’t bring it to work.  It’ll just distract you and thats where errors start to creep in, then you are REALLY up shit creek.
  6. Make your hard work worth it to you.  This goes back to the hobbies.  I know you have student loans, car payments, house payments, but once in a while you need to buy yourself something nice to reward yourself for waking up every morning and dealing with the daily grind.  It doesn’t have to be expensive.  My favorite self-treat is lunch.  Usually taco-bell, the cheap-as-shit menu, and its always cold by the time I get to it.  Don’t fucking laugh at me.
  7. Don’t self-medicate.  Seriously as shit about this one, go through the right channels to get antidepressants, anti-anxiety meds, and other Rx only shit.  You will fuck yourself over if something happens and you don’t have the paperwork to back it up.  Even if your doctor says “You know more about this shit than me, pick whatever you like”, either have the documentation in order or have a damn good story for when the shit hits the fan.  I used to jokingly say in school that “There are 2 types of pharmacists in the world, ones on antidepressants and ones who are raging alcoholics.”  You have no idea.

That’s the jist (from what I can remember) that I told these impressionable, moldable, vulnerable young people about how to survive retail pharmacy.  I’m hoping that I can single handily either save retail pharmacy, or fuck it up more than Express Scripts.

 

Oh, in case you were wondering, this wine still tastes like shit.

March 23rd, 2012 by theangrypharmacist | 59 Comments »

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