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Monday, April 30, 2007

Shame Shame Drug Game Part 1

Ah yes, the ultra-lucrative drug business. "Big pharma" and the third party healthcare providers have made an artform of keeping prices up. If I had a dollar for every time someone yelled at me about drug prices I would be richer than Bill Gates and Steve Jobs combined. I have no control over the prices. I am just a worker bee helping you to not kill yourself by taking the wrong med(s) and giving the wrong med(s) or doses to your precious little children (or your pet I am compounding for). I stick to the medical and sympathize with the price points. Perhaps if you paid with a "rewards" credit card and pay the bill off when it comes in at least you could get some enjoyment out of life...

The first game drug companies like to play is "We have this mega-great super-fantastic drug that is better than the one we put out 13 years ago!" So you made a slight change to drug "acid blocker" and duplicated the tests with "better" results and came up with the same side effect and drug interaction profiles. Not to mention that the "acid blocker" is going generic and OTC at about the same time and you stand to lose mucho dinero. So you use doctor prescribing incentives and "free" samples to get "mega acid blocker" on every prescription pad in the world. Don't forget contract pricing with third party insurance providers so you can screw the pharmacies that have to supply the public with "mega acid blocker" and try to pretend that the public will be healthier with a $50 copay when the generic OTC works just fine for 98% of patients at one-fourth of the price.

Another fun game is "This works better in extended release." Usually 12 to 14 years into the product life an extended release version is patented, approved and marketed. "Sleepy Time" has activity in the human body for 6 to 8 hours. The patent expiration date is coming up so we made "Sleepy Time CR." Not only are you sleeping longer but the "hangover" sure makes that morning commute fun! Did we really need "Sleepy Time CR?" Nope! For that matter you probably don't want to be on anything that makes you dependent on it to sleep.....the ace in the hole...once you start taking "Sleepy Time" you will always need to take "Sleepy Time." Oh no, now that "Sleepy Time" is available in the generic formulation maybe patients will lose interest in your new formula in order to save a significant amount of money on copays and avoid the messy "prior authorization" process to get the "Sleepy Time" in any form in the first place.

I know, you believe in the FDA. I used to until crap like this started happening. We need serious changes to the drug patent laws. The typical drug patent gives exclusive manufacturing rights to a drug for 17 years. I think that non-innovator drugs such as extended release or "altered and improved" products should only be given a patent of 5 years. With all the tax breaks the government gives there should not be any incentive to "beat the system to death with a stick" in order to make a fast buck.

Sunday, April 29, 2007


Oh how I love working the weekend. There's nothing quite like it. Here's a few examples that contribute to the slow demolition of my soul. The typical weekend shift starts out like this...I walk back to my cage, only to be greeted by at least two customers standing and staring at the closed pharmacy. Their eyes aglow and filled with a childlike anticipation, knowing that their vicodin is just on the other side of that closed gate. Here's the deal folks; you want to walk around the main store until the pharmacy OPENS and then come back and throw your prescription at me. This will make me hate you less and make your wait time only 30 minutes instead of the 45 i was planning to go with.
Sometime later that day, I'll get the call that makes me want to impale myself on the nearest pill counter. The person who wants me to transfer their prescriptions from another store. I have to take at least three deep breaths before I even say anything to you. There is nothing I hate more than having to call other pharmacies on the weekend because you are too lazy to get off your ass and go there before they close. Can I ask you something? How was obtaining the inhaler that you need to breath not priority one on your list for the day? "Well...let's see...big day ahead of me today, that's for sure...first, I figure I'll watch tv for about 4 hours, then I have to remember to slam my thumb in the car door so I can keep my workman's comp claim open...hmmm, what else...oh yeah, definitely watch some more tv, and then I guess if I have time I'll go pick up that inhaler that keeps me from dying." Awesome.
This leads us to my favorite part of the day: The last minute throng of regular customers who show up right before we close. We have been open for NINE hours people, and I know that you are fully aware. Where the hell have you been? It's really the perfect metaphor for your lives. Please don't wait until the last minute to do important things and then act like a child when you are once again confronted with the fact that the world does not revolve around you. You are not the Sun. I am not the Earth. In reality, you are on your own planet, where time does not exist and vicodin is the Sun. Look out for asteroids.

Friday, April 27, 2007

Thanks For Nothing

Customer: "Do you have boric acid?"
Me: "No, I'm sorry, we don't carry that"
Customer: "Well, I think my gerbil has an eye infection. What do you have for that?"
Me: "You know, honestly, I'm really not sure. I'm not trained in gerbil medicine. I would suggest calling a veterinarian"
Customer: "Well thanks for nothing!" (followed by her storming off down aisle 8)

Really? Thanks for nothing? I informed you about our current inventory status, gave an honest answer about my lack of expertise and then offered you guidance on where to go for the best advice. This is why on some level I hate 60 to 70 percent of my customers. I am polite, friendly and helpful and yet you still treat me like i just gave you cancer. I mean seriously, it's a gerbil. I don't know anything about gerbils. If I had a gerbil and it got an eye infection I would think to myself 'Well, it had a good run...I guess if this doesn't clear up on it's own, I'll just buy a mini gerbil eye patch and change his name to Blackbeard' (on an ironic side note, famed pirates Blackbeard and William Kidd once waged a fierce sea battle in an effort to finally settle their long running debate over the virtues of gerbils vs. hamsters). But i digress. The point is, don't go to the pharmacy, get free advice, and then get pissed when that advice isn't what you wanted to hear. Grow up. Act like an adult. Seriously. It's like going to Jiffy Lube and asking how to fix the engine on your lawn mower. Here's a crazy idea, maybe you should just call the store you bought it from. Also, if I could just make another suggestion to customers, don't come in, lift up your shirt to expose your stomach and ask "Is this scabies?". It's only going to make me lift up my shirt and ask "Is this my soul being slowly torn apart?" I'm not a doctor, I'm not a veterinarian, and I'm not a gerbil hater. I'm a pharmacist. Thanks for nothing.

Saturday, April 21, 2007

Poppin' Fresh

Thursday overnight shifts tend to be chock full of boredom. This past Thursday started out the same but took a turn for the amusing.

An elderly gentleman we refer to as "Old Pop" pushed his cartload of belongings back to the pharmacy and sat down in the massage chair where he fell alseep. I kept doing my paperwork because he comes in on a semi-regular basis to buy chips and use the massage chair. No worries.

About an hour later my store manager came to the drop-off window laughing hysterically. He was like "Did you look over there?" I told him I knew "Old Pop" was there and had been there sleeping for about an hour. He said "look again." So I went over and took a closer look.

Holy Elephantitis, Batman!

His family jewels were poppin' fresh out of his "Daisy Dukes!" I had a good laugh but am glad no customers saw him. The manager woke him up to "make an adjustment" and send him on his way. I hope he wears pants next visit!

Wednesday, April 18, 2007

Customer Complaint

So, I had a customer complain about me today to my store manager. According to her every time she comes in I look at her like I'm better than her and I "look down on her". First of all, don't go to my store manager to complain about me. They don't care and you are only giving us something to laugh about after you leave. On second thought, complain all you like. Anyway, he comes back and tells me what she said, so I think back and remember the top 10 reasons that it's probably true:

10. She's on state medicaid and she's a frequent flyer on Vicodin Airlines
9. She has 3 kids with 3 different last names
8. She once bought cigarettes and had to "come back later" because she didn't have 2 dollars left for her son's inhaler
7. She never came back
6. She once interrupted me when I was counseling someone to ask me "where the condoms where at"
5. She didn't say thank you and she apparently never used the condoms
4. She smokes when she has the three kids in the car with her and "doesn't need no counseling" because her kids have had the bronchitis antibiotics "tons of times"
3: She once asked me why the doctor would write for something if it wasn't covered, because she "doesn't pay for shit"
2: She said this in front of her three kids (the oldest being 7)
1. She makes me want to drive a cement filled car over niagra falls every damn time I see her face

So, yes, I am better than you. And yes, I will proudly display it every time you come in my store. Have a great day

Public Restroom Shenanigans

Is no place sacred? Can an employee not pee in a clean restroom environ? Apparently not! Public Restroom Abuse is a long-standing wave of terror worthy of a visit from Homeland Security. Our restrooms are ritualistically violated by "patrons" who may or may not be making purchases.

Such violations in the women's room include:
1. stolen merchandise packages
2. used feminine products
3. fecal matter splatter
4. urine-soaked flooring
5. cigarette butts
6. grafitti

It is gross enough being a woman once a month. It would be fantastic if other women would have the courtesy and hygiene to dispose of these items properly.

Such violations in the men's room include:
1. stolen merchandise packages
2. fecal matter splatter
3. urine-soaked floor
4. cigarette butts
5. half-eaten McDonalds's sandwiches
6. hair-coloring (all over plus packaging)
7. grafitti
8. ejaculate and lube

Now, the ejaculate and lube was from a Friday night. One assistant manager stayed late to help face the store because it was only the overnight manager and myself to run the entire store. The late assistant told the overnight manager that a young guy had stolen some lube. The overnight manager had forgotten about it. While facing the lubricant aisle, he noticed a tube of Elbow-Grease lube was practically empty. The young man had squirted it into his palm and proceeded to the restroom for a one-man show. We know this because the overnight manager had gone to the restroom and saw the resultant puddle of ejaculate and lube near the toilet.

I want my own private restroom!

Tuesday, April 17, 2007

Hey doc--do you have time to kiss my ass?

So it is almost time (9:50 PM) to close up shop and the goddamn doctor's line rings. I was enjoying a few minutes of bliss since Grace and Gratitude had not played in the last 8 minutes and my last drive-thru customer was rather pleasant in a pervy kind of way. I pick up the phone praying it was one of my colleagues calling to rant about a nasty customer (what a support group we have) but nope--it was Dr. IamaGod.

The following is our actual conversation:

"Hi. This is Dr. I amaGod. What time do you close?"

me: "10"

him: "10 PM?"

me: inside voice: "NO! 10 am! What do you think? What store CLOSES at 10 AM?" but I said in an annoyed voice "Yes, 10 PM"

him: "Good. That will give you enough time to fill this prescription."

me: "Oh will it?"

him: "Yes."

me: "hmmm"

him: "You will fill it."

me: "Are you asking me or telling me?"

him after a bit of silence: "Just fill it."

me: inside voice "Oh really? And what if I don't?? Are you going to cry to your mommy?"

What a jerk. Needless to say I filled it for the patient's sake but the patient never showed up.

What a waste of my time.

Sunday, April 8, 2007

Ask for an ID, unless it's me

Some patients get paranoid, so they request that we see an ID every time they pick up a prescription.

Fair enough. You want security, fine. Just make sure you remember that ID every time!

Tonight, I had to deal with a whining, crying patient without an ID.

What did she think this meant?

I had never seen this woman before; she went to another store for everything until today. How do I know she isn't an imposter?

So, I said "NO, I am bound to follow YOUR instructions".

People want to have it both ways. They want total security, but they want us to break those rules if they mess up. Make up your mind! Either we ask an ID every time or never. We don't know who you are! We've never seen you before!

How Hungry Are You?

Many studies have been done in order to isolate causes and contributing factors to the scourge of obesity smothering the nation. I am addressing one particular concern: Are you really that hungry?

Every day at work or shopping I see a great problem: people who feel the need to eat the items they are purchasing while they shop. There is no way that all of the people I see eating a gigantic bag of Ruffles and drinking a Yoo-Hoo while pushing a cart-load of junk are stoned. It is also not possible that the 500lb man eating cookies really can't wait to get home to break open the box. Hey, fat boy, what is up with that? I wonder why your blood sugar is raging out of control. Hey you, lady with the ass trying to reverse digest a chair and crying into a plate of donuts with a double espresso latte, maybe this is partially why your toes have gangrene and you feel like crap all day long,

I don't say these things to be cruel. I myself am known to overindulge and be utterly lazy. The difference here is that I am overweight but I can still see and touch my toes. My blood sugar is relatively normal. I do not get frequent infections in weird places. I can run three miles before I need to sit down. I can also shop for food, pay for it, drive it home, put it in its proper kitchen resting place, and sit down to enjoy my chips and beer when said shopping excursion is over and done: not while I am in the process of shopping.

Moral of the story: DON'T EAT IT TILL YOU GET HOME! That way you have at least burned off a few calories between picking up the chips and eating them instead of eating them and going back to get another bag to take home.

Saturday, April 7, 2007

Hazard Pay

We live in a world where everything is designed to make you want to part with your hard earned dollars. End stands are used to market profitable items you probably don't need but buy because it is there and catches your eye. This is especially true of those "compulsive" items you pick up while waiting in line at the checkout. These same retailers use the background music to make you relax, stay a while and spend that money.

I know that research shows which songs, genre or groups may induce this state of "spend nirvana" but I, dear reader, do not agree. After hearing practically the same fifty or so songs over and over and over and over I do not want to spend money. I want to cry. I want to walk out and never come back to work. I want to slit my wrists in a bathtub. I want to rob a bank. I want to punch the person(s) responsible for this play list in the face and the genitalia. But let us not go to extremes.

A simple solution to this problem for me is "hazard pay." Any time a song is replayed that induces extreme rage or depression it should mandate a pay-out of $100. Since the music kicks out an offending song about every 10 minutes I will be well compensated at the end of a ten hour shift. This compensation will pay for relaxing spa visits and psychotherapy. I won't have to go "postal." It is a simple solution all retailers should look into. After all, I do fill your family's prescriptions. You want me to be happy!

Friday, April 6, 2007

I put a tie on for this?

Easter Sunday is fast approaching. Now, I am not a religious person by any means. However, Easter will forever be special to me as it is the anniversary of one of the most vile moments I've had in pharmacy. Two years ago at about 7am on Easter morning, a small framed woman (probably in her early 80's) came in concerned about a recent problem. She had been on doxycycline (an antibiotic) for the past 3 days. As expected (by me, apparently not her) she subsequently developed diarrhea.

Personal, somewhat yucky sidebar here... being a 'good times' kind of guy with a penchant for vodka, I have had many wonderful Grey Goose fueled evenings of harmless debauchery. Consequently, I have also not had a solid bowel movement since 1997 (a wonderful respite provided by the constipating side effect of Tylenol #3 prescribed after dental surgery). Needless to say, I am unbothered by the occasional presence of diarrhea. Water in, water out. It's the circle of life. Replace what you waste, and everything will be just peachy.

Anyway, back to the Easter story. This very nice lady began filling me in a little on her recent medical history - how poop soup began brewing pretty much on day 1 and she had been concerned ever since. As fellow blogger Big 'N Tasty (and any other pharmacist) will attest, a good portion of the questions we answer have to do with helping people either stop or start pooping. Ours is a profession of glamor and riches indeed! After listening to what she had to say, and asking a few questions to help me make a better assessment (and to rule out the remote chance of something more serious), I launched into my speech about how diarrhea is often an undesirable, yet minor side effect of many antibiotics. (A teaching point for non-pharmacists... clindamycin is an antibiotic that diarrhea is deemed a serious, therapy-ending side effect)

I was starting to wrap up our session with some advice on how to manage the problem, when she reached into her purse for 'Easter goodies'. She said that she was glad that she came in, and brought with her a 'sample' ... just in case. (?) So this sweet, elderly lady whom I was thrilled to help just minutes ago, reaches into her purse and pulls out a Ziploc freezer bag containing diarrhea soaked toilet paper - in case I 'had any questions'. The only question I had at the time was "What the fuck?"

So I guess I totally blew the assesment. This was indeed a serious problem. This customer has obviously shit herself crazy!

Keep in mind that I'm working completely by myself at this time of the morning, and a small crowd of would-be customers has begun gathering for prescription pick-up, medical advice, or to pay for overpriced garbage (ahem, 'merchandise') from the sales floor. (I could go on about spending five years in a hellishly difficult pharmacy school for the privilige of ringing up Yoo-Hoo and lube, but that's a topic for another blog). Oh, gather around the pharmacy counter one and all. Make sure you get a good look at this bitch's bag of toilet paper soaked in watery shit!

After taking care of her, grief counselling the innocent bystanders and swallowing the vomit in my mouth, I called Big 'N Tasty at her pharmacy to relay the story. "Yeah, on holidays our customers usually just bring us cake", she said as I slammed the phone down to no longer suffer her tortuous cackles. I really hate her sometimes.

So, Happy Easter, I guess. =)~

Thursday, April 5, 2007

A Simple Observation...

Drive Thru Etiquette Part 2:

Up until I started working at McDruggie's, I had foolishly assumed that common sense was, well... common. Typically, I enjoy having a friendly, somewhat casual relationship with my customers. It passes the time and makes the day not suck quite so much. This was the case for much of my shift last night until I heard that sound that makes the chosen few cringe in disgust - the melodic and lilting 'ding-dong' of the drive-thru. For the unindoctrinated, please know this - you need not hit the call button after pulling into the drive-thru. Trust me, we are well aware of your presence. If we don't come running right away, chances are better than great that we are busy. Be patient, my patient.

Call it a sixth sense, but immediately after the first bell, I knew what was coming next. All of the phones in the pharmacy started ringing very loudly at once. This is what happens when the impatient patient hits the call button. It is unintentionally rude, but very veeeeeerrrrrry annoying to those who happen to be in the pharmacy. I can certainly understand if somebody has been sitting in the drive-thru unacknowledged for a couple of minutes and they hit the button out of confusion. But the one-two punch of both of those bells really sets my soul on fire.

I put on my happy mask as I walked to the drive-thru, which turned into a genuine smile when I noticed what was happening before my very eyes. The young man who had chosen to use our drive-thru service had pulled his car up a couple of feet more than normal so he could open his door. He stepped one foot out of the car and stretched his now contorted arm through the small opening he was afforded. You see, his window did not have the ability to go down.

Now, I understand that the drive-thru must be a god send to those who are handicapped, the morbidly obese and those who have been 'blessed' with a whole litter of children (it's a vagina, not a clown car). But if you are a young, healthy man in the prime of your life... and your car window doesn't have the ability to roll down, maybe you should just walk your happy ass inside.

And if you hit that fucking button one more time... I'm sticking a booger on it.