Cashmere Posted July 12, 2012 Share Posted July 12, 2012 I once asked the pharmacist on duty at my local grocery store what type of over the counter medicine I should take for my cold like symptoms. He looked at me like I was crazy for about 4 seconds, and then gave me a few options, ultimately settling on one that should work for everything. I had already asked my brother, but I figured the pharmacist would be happy to actually be consulted for his professional opinion. I think he was a bit socially awkward though, so it didn't go as well as I had hoped and I haven't talked to him again. I am going to email my brother asking for a description of his day-to-day as a commercial pharmacist. Hopefully I will be back soon with more info. Link to comment Share on other sites More sharing options...
Frexspar Posted July 12, 2012 Share Posted July 12, 2012 Yeah, but we're all pretty healthy. And I'm assuming we have pretty mundane prescriptions to fill. I don't remember the last time I had a prescription that wasn't antibiotics or birth control pills. My grandparents have a pretty good relationship with their pharmacist. She's recommended medications to them before, and even called the doctor to have them prescribed. Of course, they're all on like 5-6 medications each, and they take supplements (which were also a pharmacist recommendation.) This is a good point. My trips to the pharmacy are pretty rare and probably fairly mundane compared to someone who is on regular treatment for a condition that requires a lot of meds and would have to be concerned with the mixing of a variety of drugs. Link to comment Share on other sites More sharing options...
Lace Mindu Posted July 12, 2012 Share Posted July 12, 2012 Sounds like your grandparents have a good pharmacist. I'll give you my take on pharmacists: Not all pharmacists need to be Pharm.D's. They're the "elite". Alot of them that I dealt with back in my drug rep days were "Consulting pharmacists", working with wholesale drug companies on one side, or nursing homes or hospitals on the other to oversee drug useage for large populations and recommend ways to save (or make) money, reduce interactions, get people off unnecessary stuff, etc.. Basically a pharmacist oversees the administration of the drugs, yeah. In the old days (very rarely now) they actually MADE the pills (called compounding) -- add chemical A to chemical B and put it in a capsule or pill to get it into the body. Not much call for that these days but some still do. But they have to know about the human body and all about the drug and how it acts to spot drug interactions and to council you on what's going to happen when you take it.. Not so much for me or you, we're boring and can take the info right off the package, yeah -- but it gets hairy with old people. Your average old person is on like, 9 different things and that's not even the tip of the iceberg compared to those in the hospital. They have to know about how the drug is illiminated to make sure the various docs and drugs are not overstressing your kidney or liver (or brain with old people, they get crazy fast), about dosage levels to oversee what the doc is prescribing and prevent 90-lb granny from getting a dose that would sedate a 300-lb horse, etc. They have to know what's an "upper" and what's a "downer" about things to prevent 2 prescribed drugs from different docs cancelling each other out. Oh, and they have to make sure the right patient gets the right drug, too. So basically, if this were government, it's another arm to prevent people from doing harm. It's not the Office of the President, it doesn't get the glory, and it's hard and mundane work sometimes, but important. Always hard to correct a doctor, of course, but having someone looking over a doc's orders isn't the worst of ideas, either. Plus, they give you someone extra to ask questions after you've seen the doctor. They also take care of all the boring administration stuff -- from sitting on the formulary committees to decide which drugs the place should carry, to negotiating prices and choosing suppliers/wholesalers, to ordering the stuff, getting the labels and bottles, filling them all, and taking care of the mounds of paperwork that all that brings, especially when you're talking rare, dangerous, or addictive substances. They need to know which generics are good and which are not so hot or more dicey, since generics can vary more than brand name drugs. When you're at a big hospital or nursing home or even drug store, inventory management itself is a bitch, especially tracking drug expiration dates and the proper procedures for getting rid of expired drugs and getting credit from the manufacturer if you can, etc. Plus keeping the right qunatities of the right drugs in stock, giving flu shots, selling vitamins or whatever else they do. Throw in dealing with medicare/medicaid paperwork, indigent patient programs and insurance company reimbursement, plus Federal Drug Administration policy and procedure for controlled substances, and it's a full day. Oh, and they have to track all this stuff to the minutest detail to make sure drugs are not "disappearing". And yeah, many times they also have to council patients about stuff at the window and know when a non-prescription drug'll do the trick, and when to tell them to get to a doctor. So they have to know all about non-prescription and herbal stuff, too -- it interacts with prescription stuff just the same, too. They also need to keep themselves and their staff educated about new drugs, recently discovered side effects or safety issues, new drug delivery systems, etc. They're substitute doctors without the paychecks, prescription-writing privledges or prestige...but then, they didn't have to go to school as much, either. My gut feeling is it's kind of like nursing -- you have to get a lot of education for it that you end up not using all that much unless you catch someone REALLY messing up. Since for a lot of your career you're doing repetive grunt work and merely hoping you get a promotion to where you can at least run something, supervise staff or otherwise have a little power. Link to comment Share on other sites More sharing options...
Cashmere Posted July 13, 2012 Share Posted July 13, 2012 Here is the novel my brother provided when I asked him what a typical day looked like for him at the Walmart pharmacy: Come in about half an hour before the store opens. After a few minutes putting things in place from whoever closed the day before, you get started working on the problem issues. Things like insurance rejections (of which there are hundreds, and take a lot of expertise and individual attention to solve), or problems that need a response from the doctor that popped up after the doctor's office had already closed yesterday, and also people who have requested a refill when their previous prescription didn't have any left will also require you to fax or call the doctor to see if they want to authorize refills. Hopefully you can get this done quickly, and get to work on filling the backlog of prescriptions before opening time. Doctors and emergency rooms will send electronic prescriptions, and people will use the automated system to phone in refills overnight. Your garden variety pharmacy will probably have 50-150 prescriptions waiting in the queue before the doors even open. Ideally your technicians do most of the actual filling process, but the pharmacist will do as much as possible before the doors open. Once the doors open, you're working to keep pace with the high-priority prescriptions. The pharmacist is legally responsible for the final verification both of the prescription order as it enters the pharmacy system, and for the final prescription product that goes out the door. So for every prescription that is filled, a pharmacist must confirm all of the prescription information is accurately transcribed into the system, and then verify that the right quantity, dosage, and patient information is going out the door as well. If you have a really good technician, they can troubleshoot insurance issues while you're focusing on those steps. If your techs suck, then you're also solving those problems. Most pharmacies have a system that will prioritize prescriptions by whether the person is in the store, coming back later, just requesting a refill over the phone, etc. Additionally, by law, the pharmacist is the only one who is able to provide advice to patients. So anyone who asks which product to buy for a cough, or what type of gauze is best for a wound, the pharmacist has to speak with them directly. Techs can help with questions about where to find something, but nothing that could be construed as advice. Also, in most states, for any prescription that comes in for a Schedule 2 Controlled Substance, (basically the heavy hitters, like percocet, adderall, morphine, etc.) the pharmacist is responsible for that prescription from start to finish. They must double count the quantity, and also double count the quantity remaining in the bottle for verification. To fill a 90 count of oxycodone from a 200 count bottle can take quite a bit of time. This must be tracked in a separate log book which is audited at least monthly. Throughout the day, patients are calling with many different issues. Some, such as refill requests and price-checks, can be handled by a technician. Many can only be handled by a pharmacist. It is common to get questions about medication side-effects, "can I drink with this?", advice for how to take something, why their vagina is so dry, etc. Additionally, only a pharmacist can take a verbal prescription order from a doctor, and taking all the information over the phone can take quite some time. Any time there is a question or a mistake with a prescription that may require an adjustment to the written order, only the pharmacist can make that call to the doctor. Finally, you have transfer requests. Many people don't realize, but if you get a prescription filled at one pharmacy (say CVS), and it has some number of refills remaining, you can have those refills transferred over to Rite-Aid or whatever pharmacy to get the remaining fills (though some state laws restrict this to a degree.) Again, only the pharmacist can take or make those calls, which require not only providing all of the information over the phone, but also taking the record-keeping steps to remove it from your own system. Each day when the order of controlled substances arrives, the pharmacist must sign for this, compare the receipts against the received items against the order record, and promptly enter all of the received quantities into the inventory system.Many state laws require that the pharmacist do an additional verification to confirm that the records for controlled substances match the prescription before the end of the day. If you have a slow evening, you fit this in between checking and filling prescriptions. If you don't have a slow day, you do this after the pharmacy closes. On top of all of this, the pharmacist is generally the manager on duty, so they may be tasked with scheduling, payroll, conflict-management, training, etc. As a note, most states require that the pharmacist provide face to face counseling for every new prescription that goes out the door (refills are typically excluded from this requirement), which is maybe 120-160 prescriptions in an average pharmacy. There has been some criticism that pharmacies often dodge this requirement, using some vague language to claim that it was offered and refused, or simply noting that the patient refused counseling without ever presenting the option. While the requirement to counsel each patient is well-intentioned, the current realities of the job means that it is essentially impossible in the current system. In a typical day, I would maybe provide face to face new-prescription counseling for one or two patients, if they responded "Yes" to the question "Do you have any questions for the pharmacist today?" As a rough estimate, most stores will have about one pharmacist shift for every 175 prescriptions or so. Pharmacists are judged on speed, customer service, generic fill rate (usually), and some other metrics. But, above all, in the fast-paced, always-underwater atmosphere of a retail pharmacy, they are judged on accuracy. Mistakes are classified into multiple levels, but a single mistake at the level of the wrong medication being given to a patient (even if not dangerous), or one patient's information being given to another patient, will merit a discussion with your supervisor at most chains. A fill-accuracy rate of 99.98% is typically a fire-able offense. Link to comment Share on other sites More sharing options...
Guest bodega Posted July 13, 2012 Share Posted July 13, 2012 I know a couple chicks who are pharmacists. Couple of the dumbest, sluttiest broads I know. But its not a conclusive sample pool. Link to comment Share on other sites More sharing options...
Guest Letsgo_7_7 Posted July 13, 2012 Share Posted July 13, 2012 LM/Cashmere thanks for the replies. That more or less, answers my question. Link to comment Share on other sites More sharing options...
Guest Posted July 13, 2012 Share Posted July 13, 2012 The one thing I would add is that the pharmacist also is capable of compounding drugs. There are a lot of medications that work well together, but the combination isn't worth making for a large pharmaceutical company. That's where the pharmacist comes in. They can mix those for you. Now a Wal-Mart pharmacist probably is only going to be allowed (by the company) to make very basic, easy compounds, if any. But the smaller, non-chain pharmacies will do a lot of these. Some of these are going to be so easy that you could do them at home with a high school education, but some are much more complex. When I worked in a pharmacy, the pharmacist was very lucky that I took care of the management aspect, so they only had to worry about those things while I wasn't there, but they can easily spend half of their day helping people determine over-the-counter products that will help with a condition or injury or convincing those same people that there's nothing OTC that will work and they need to see a doctor. I can't even count the number of times I've had bleeding people come up to me and ask what they should do, or how many times I've answered the phone to hear "There's white stuff oozing from my vagina, what should I do?" Link to comment Share on other sites More sharing options...
Ms. Spam Posted July 13, 2012 Share Posted July 13, 2012 The pharmacists I know work selling drugs for drug companies and no longer work in an actual pharmacy. Link to comment Share on other sites More sharing options...
Evolence Posted July 15, 2012 Share Posted July 15, 2012 Here's my take on pharmacists... 1. Either don't require all the fancy training and develop computers to flag potentially dangerous medicine combinations, etc. I mean really, a computer would probably be just as effective at cross-referencing medications a patient is prescribed to make sure there aren't any dangerous combinations. 2. If you insist that pharmacists get all the current training...Expand what they do to include writing "simple" prescriptions. I'm not sure if pharmacists would be qualified to manage long-term medical problems (heart conditions, etc.)-- but surely they could write a script for antibiotics, birth control, anti-fungals, etc. Link to comment Share on other sites More sharing options...
Rock Posted July 15, 2012 Share Posted July 15, 2012 I had a pharmacist correct a former doctor of mine about a new medication he prescribed me. Pharmacist had reviewed all the medication i was taking and spotted that there was a conflict with the new one that might have put me into cardiac arrest. So that's what they "do" and why they are trained so heavily. Link to comment Share on other sites More sharing options...
Ryn Posted July 15, 2012 Share Posted July 15, 2012 Here's my take on pharmacists... 1. Either don't require all the fancy training and develop computers to flag potentially dangerous medicine combinations, etc. I mean really, a computer would probably be just as effective at cross-referencing medications a patient is prescribed to make sure there aren't any dangerous combinations.There are systems like that in place, however, with so much drug information from the drug companies there are gaping cracks in their effectiveness. The systems work as well as the insurance programs. The only stable data are long-available medications. 2. If you insist that pharmacists get all the current training...Expand what they do to include writing "simple" prescriptions. I'm not sure if pharmacists would be qualified to manage long-term medical problems (heart conditions, etc.)-- but surely they could write a script for antibiotics, birth control, anti-fungals, etc.I think PharmD's can. However, an examination is still required and there isn't much place for that in current environments. Some businesses are trying to fill that care gap though with on-site clinics. Link to comment Share on other sites More sharing options...
Guest Posted July 15, 2012 Share Posted July 15, 2012 I think the answer is having two levels of pharmacists. Big pharmacies aren't likely to ever allow their pharmacists to prescribe, because they make the most money by getting the most number of prescriptions filled, and taking time out for even a cursory examination before prescribing something will cut into that. Especially as more and more people take advantage of it. Your Walgreens and CVS pharmacists aren't going to do it. Maybe some of the grocery store pharmacies, since they're already loss-leaders for the store, but otherwise it would just be the smaller pharmacies. So you have a level that doesn't compound, doesn't prescribe, and maybe is a 4 year degree plus a license and then you have PharmD's who can do everything. Link to comment Share on other sites More sharing options...
Letsho_7_7 Posted July 16, 2012 Share Posted July 16, 2012 I'm sorry if I offended anyone with my posts in here. I shouldn't have insulted pharmacists. Being a Legal Clerk Lawyer, I push paper and chase ambulances. They at least push medication which helps saves lives. Hope everyone has a very good evening. I'm going to go now and shovel Ben and Jerry's into my fat skinny face and reflect on how pathetic wonderful my life is in this ****hole city New York. Link to comment Share on other sites More sharing options...
Cicirunner Posted March 10, 2016 Share Posted March 10, 2016 I work as a pharmacists for a small chain pharmacy and I literally spend my entire day answering phone questions from confused elderly patients and explaining medications in great detail that was never covered in the doctor visit. A lot of these patients have no idea what they are taking and why they are taking it. I have people come up and say, "Fill whatever needs to be filled" as if they don't care what goes into their body. I always check each one with them individually to ensure they understand the importance of each medication. Dose changes are very frequent with prescriptions, and a lot of times the doctor's office does not tell the pharmacy. I catch these dose changes, because I get to know my patients and become familiar with their medication regimen. Sometimes I catch dose changes that were prescribed by mistake. Other times I mention the dose change to the patient and they have no idea about the change; in which case I educate them about the reasoning behind the dose change and what kinds of symptoms they can expect as a result. I believe the pharmacist's greatest role is being the last line of verification before the patient receives their medication. I catch many errors every day. The level of inaccuracy for some of these doctor's offices astounds me.........clearly because the doctor's untrained staff have a greater role in the transmission/verification of prescription orders than they should. Link to comment Share on other sites More sharing options...
Driver Posted March 10, 2016 Share Posted March 10, 2016 That and scouring the internet for slights that are 4 years old. Link to comment Share on other sites More sharing options...
Guest Posted March 10, 2016 Share Posted March 10, 2016 Don't we ALL do that? Link to comment Share on other sites More sharing options...
Cerina Posted March 10, 2016 Share Posted March 10, 2016 I do not remember this thread Link to comment Share on other sites More sharing options...
Driver Posted March 10, 2016 Share Posted March 10, 2016 Don't we ALL do that?Only when I want to prove somebody wrong. So yes. Link to comment Share on other sites More sharing options...
Carrie Mathison Posted March 14, 2016 Share Posted March 14, 2016 Wow well this is a blast from the past. I honestly cannot for the life of me remember what made me so damn curious about pharmacists. But while I'm here, hey admins- my LG (and I assume my A777 name) appear as deleted... any possibility of getting them undeleted? Come on, I've been good (mostly) for like several years since I was last banned. Pretty pretty pretty please???? :) Link to comment Share on other sites More sharing options...
Guest El Chalupacabra Posted March 14, 2016 Share Posted March 14, 2016 What? The 500 aliases you created for yourself in the mean time isn't enough? Link to comment Share on other sites More sharing options...
Odine Posted March 14, 2016 Share Posted March 14, 2016 What did you get banned for? Link to comment Share on other sites More sharing options...
Guest Posted March 14, 2016 Share Posted March 14, 2016 But while I'm here, hey admins- my LG (and I assume my A777 name) appear as deleted... any possibility of getting them undeleted? No. Come on, I've been good (mostly) for like several years since I was last banned. Pretty pretty pretty please???? :) You could create new accounts with those names, but once an account has been deleted, there's no way for us to undelete it. Link to comment Share on other sites More sharing options...
Carrie Mathison Posted March 14, 2016 Share Posted March 14, 2016 Aw man. Really? I was always sorta fond of my A777 one, just because it was from Jun '99 and one of the oldest names still posting here. Oh well. Link to comment Share on other sites More sharing options...
Driver Posted March 14, 2016 Share Posted March 14, 2016 If you want a 99 reg date maybe they can unlock "Tank" for you Link to comment Share on other sites More sharing options...
Carrie Mathison Posted March 14, 2016 Share Posted March 14, 2016 You know I was wondering, why did you stop using Tank anyway? Link to comment Share on other sites More sharing options...
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