Pharmacy and Your Niche

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What led you to choose pharmacy as a career? For me, it was a mention of "oh by the way, I am not only a chemistry advisor, I am a pre-pharmacy advisor" by a brilliant analytic chemistry professor, Dr. Anthony Harmon. I was just 21 years old, and I did not know what I wanted to be when I grew up. He pointed me toward pharmacy. I envied the quiet genius a lot of the serious chemistry majors seemed to possess. I was a more outgoing having fun type. Dr. Harmon told me a career in a chemistry lab may not mesh well with my personality. Well, let's be real... I wasn't an A student in his quantitative analysis class either. Pharmacy was suddenly on my radar.

I took the PCAT. Who knows what I made. My undergrad GPA was 3.2. Being female used to be a minority, but not in pharmacy in 1993. In fact at the time, being male was the minority. I was finishing my third year of undergrad and decided I'd apply to a handful of universities.

I had a couple of acceptances but really wanted the University of Tennessee at Memphis. I was told on the phone I was 99.9% in, so go ahead and respond decline to the private universities who accepted you. I turned down the schools and then received a rejection letter from UT. Guess i was that 0.1% eluded by the assistant dean. Talk about a downer. A lot of students do go the political route and a lot of acceptances are based on who you know, but I didn't until the rejection.

I reached out to some "who you know" types with my story and got accepted for the next year. So... I spent my fourth year in undergrad finishing a degree and biding my time. At least I did not have to reapply.

So there you have it. I remember thinking the pharmacist who worked in my small hometown had a large house. I didn't realize it wasn't pharmacy more than the sheer fact he had his own business. This is key.

Thirteen years later I realize you can make a good living in pharmacy or a great one in finding your niche within.

Have you found your niche?

The Most Hilarious (and not-so-hilarious-moments) in the Past 10+ Years of Pharmacy

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This post has been long time in the making, and also a move toward a coming out of sorts for the Blonde Pharmacist.  It is time to just be me, if you know what I mean, so let's start out with a post about the past.  The most hilarious moments in the past 10 years of being a pharmacist (and not-so-hilarious-moments). 1.  Sometime during 1999, Keith Urban was living in the middle Tennessee area where I was working.  He wasn't a bit name at all, and in fact, in the Country Music City to make it.  (Make it, he did).  I worked in a small retail pharmacy with a fabulous technician named Kim and another pharmacist named Ladona.  Keith came in from time to time with his fabulous Australian accent.  Of course, I cannot divulge what he took medication wise, but I can say that he is indeed short, and was friendly.  It wasn't too much longer he sent in a driver...  he made it big.  This is a hilarious moment only because it was my only brush with celebrity while working.  Fun stuff.

2.  I was a floater for the same retail company and was working in a store one afternoon.  The best part of being a floater is that there isn't a lot of responsibility as far as the operations part of the day.  I would go in, do my job, and leave.  However, this one day, there was a man that came in holding what looked like a five year old needing an early refill on his son's albuterol nebules.  I told him he'd have to pay for them because TennCare wouldn't cover them early.  He was irate and began squeezing his son.  "Daddy!  You're squeezing me.  You're hurting me!"  He replied to his son rather dramatically, "Son, I'm not hurting you, SHE is!!"  As a twenty-something pharmacist, I sort of lost it at that moment.  "What am I doing a jedi mind trick on your son?"  It wasn't long after that, I knew retail wasn't for me.  I couldn't let it roll. I kept going with him, "I'm gonna have your job!"  He said angrily.  "You can have it!"  I replied.

If I can give some advice here it would be... learn to let it roll.  Don't lose your cool.

3.  JB.  The HIV positive homeless man that threatened to have my brains on the parking lot if I didn't fill his alprazolam 2 mg QID two weeks early.  Needless to say I didn't, and he was my last straw.  Good-bye retail forever.  I figured JB didn't really have much to lose.

4.  AG the former crack addict who kicked the habit for many many years only to die after shooting up again.  Some of the conversations we had were priceless in hindsight during a time I needed friends so desperately.

5.  Not a hilarious moment or not - but a moment where this blonde pharmacist worked for THE BLONDE pharmacist.  She was such a positive influence and hired me for home infusion with no experience.  Glad she gave me a chance.

6.  Who could forget the boss I had once who wanted to know what I was thinking once during a meeting.  The guy had more degrees than anyone I've met but yet asked the strangest questions.  My response, "Last time I checked, thoughts were still private property."  LOL  Seriously though, he sort of lost cred with me when a close friend and coworker was in labor and he stalled her for awhile to wrap up some things with her job and then took time later to brag about how he stalled her while she was in labor.  Gag.

7.  Who could forget the manager who threatened a punitive write-up in one sentence and the next began talking about Jesus.  Asked me if I had found a church.  So wrong on so many levels.

8.  Or the job interview where the pharmacy manager dove right in with the first sentence, "We'll begin our interview."  The next sentence, "Do you have kids?"

What are your most hilarious and not-so-hilarious moments in pharmacy?

How to Be a Better Pharmacist

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Don't you remember graduating pharmacy school with all the hope in the world? Pseudomonas treatment options were on the tip of your tongue, and all those "older" pharmacists, let's face it, are SO behind the times. You knew it all, or so you thought at least. Confidence? Maybe so, or maybe an over inflated ego. If you attended a clinical type pharmacy school as I did, the idea of working retail was frowned upon. You were considered to be selling out. (I sold out... At first).

1. You absolutely must keep up year to year. Your education does not end the day you graduate. There's the boards, passing the state exam, and keeping up with continuing education. That window of time between what's printed and accepted by all to the newest guidelines should be studied. Know where to search. Be a google pro.

2. Consider challenging yourself with becoming board certified. If you fail the first time, take it again.

3. Be a team player. If you are clinical, work hard to treat dispensing pharmacists the way you would want to be treated and vice versa. The best model would be for most pharmacists in a department to be clinically trained.

4. Be tech savvy. Most health calculators are online or you can buy apps to help. I still can't believe the company I work for isn't 100% paperless. It's coming, and I can't wait.

Keep up... Because it won't be long, and you will see new graduates flooding the market, and you will recognize them eyeing you as one of the older pharmacists!

Healthcare Reimbursement

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If insurance companies are now tying reimbursement with patient satisfaction survey scores, then the same should apply to other areas of life. That Walgreens tech was rude to me, so my prescription is discounted. The cashier at McDonalds was terribly immature and the damn coffee machine was broken yet again. Free meal. How can this happen?

A doctor's personality should have nothing to do with his payment. But we all know a doctor with better bedside manner would influence the patient to rate them higher.

I hate the direction that healthcare is turning.

Management 101

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Why is it more important for pharmacy schools to teach pharmacotherapy and kinetics but avoid teaching management? While it is important to understand how a reaction between Bactrim and warfarin will change previous outcome, isn't it equally important that a pharmacist manager knows how to manage? I spent hours memorizing classes of drugs but never once learned the rules of being an employee or a manager. I thought I'd go over those now... 1. A good manager communicates well. He not only communicates thoroughly and succintely in email, he will pick up the phone to schedule the more serious things. Emails and text messages should only be used for short messages. Anything serious in nature should require a phone call.

2. A good manager will not under any circumstances make promises that can't be delivered. Not only does this build distrust, it also gives an employee something to bitch about.

3. A good manager would never ask an employee to write up or monitor their peer. Again, mistrust.

4. A good manager thinks about how decisions affect their employees. If the employee is going to be deeply affected, a personal touch with explanation is probably the way to go.

5. A good manager doesn't keep the riff raff around to use for all the crap jobs.

6. A good manager isn't a manager obsessed with punitive action.

7. Remember positive feedback is more important than you think!

These are just a few of the tips I'd highly recommend a pharmacist manager begin with learning. Be fair, trustworthy, and logical. Care about your employees. Call them rather than blasting off an instant message or email. Don't accuse them for lack of communicating when all of your communications are short sentence fragments via email.

Walk the walk.... don't just talk the talk!

Pharmacy Drive-thru and the Demise of Professionalism

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What do McDonald's and Walgreens have in common? A drive-thru. That's right! In my local city, a pharmacy drive-thru wait time can easily approach 15 minutes. Seems to me they are counterproductive. So for your reading pleasure, some links to drive-thru rants and observations.

I just want somehow for the pharmacist to stop trying to counsel me on new medications.

1. Someone got trapped in one.

2. Drive thru etiquette

3. Pharmacists believe delays and errors more common due to drive-thru.

4. Ban 'em.

Crime and Pharmacy

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I have been visiting this topic over and over... both on the internet searching around, in the local paper which shouts of a 40-something year old woman who is robbing local pharmacies (with a gun), memories from my own past of being held up at gunpoint, and discussing with a retail pharmacist this past weekend in regards to how unsafe it is. (HERE at least). An article quoted in full:

Local Pharmacies React To Rise In Crime As Demand For Certain Prescription Drugs Escalates

In light of the recent shooting pharmacies are on high alert.

The shooting that took place Sunday morning at Haven Drugs in Medford has caused many local pharmacists to focus on the alarming statistics that crime in pharmacies across the region is skyrocketing, as the demand for certain prescription drugs, namely strong opiate painkillers, is increasing.

Michael Hushin, owner and manager of Lakeland Pharmacy in Ronkonkoma said he has already been robbed at gunpoint about a year and a half ago. He now has controlled substances locked away, has obtained a pistol permit and keeps a baseball bat behind the counter.

The armed robber had come to Lakeland Pharmacy for 80mg Oxycodone.

"The biggest strength they make. It's the major score right off the bat," said Hushin.

He was alarmed about the recent shooting which seemed to fly in the face of all reason.

"This particular case was extremely different, there was absolutely no provocation. I don't even know how you protect against that," Hushin said.

When Lakeland Pharmacy was robbed, a man handed over a note, and then came behind the counter. Hushin said, "He was armed. He wanted one thing; and we tried to give him what he wanted."

Store customer, Jessica Greig, 18, said, "I'm going into the medical field. I would never work in a pharmacy now."

She is also more on guard as a customer.

"If I saw someone sketchy, I would definitely run out of the store," Greig said.

According to Hushin, some stores are considering not stocking certain medications.

"I don't know if I'd go that far. It's not fair to the people who need the medicines," he said.

Hushin said this is the second or third death of a pharmacist that he knows of occurring in the last six months, in the New York area.

"They were all robberies. Some of them very brazen, all related to pharmacy theft for opiates."

Slater Pharmacy's pharmacist Martin Robinson said that while they have never experienced a hold-up in their store, he was still shaken up.

"People don't realize that just by going to work each day your life is in danger," he said. "We're dealing with very desperate people."

The store has some basic precautionary measures in place such as surveillance cameras, asking customers to remove hats and sunglasses, and is considering not stocking certain medications.

"It's hard to be helpful, and deny people at the same time," Robinson said.

"My husband gave me a kiss goodbye because he knew I was coming to the drugstore," said Debbie Breithaupt, a longtime customer of Slater Pharmacy. "It hit home. It's just another place they made us feel unsafe."

Rick Ammirati, owner of Friendly Drugs, said he hasn't experienced any increase in criminal activity, or heard of anything unusual in the area. He does, however, have friends in the industry that have had robberies.

"It just puts you on high alert to take a second look at everybody that comes in now," said Ammirati. "It's heightened awareness."

 

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There IS a rise in pharmacy crime. It IS riskier to be a retail pharmacist today than thirty years ago.

Gunned Down

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There they are. The two arrested for the horrific pharmacy murders. Apparently the female here had an oxycodone habit that her husband was trying to feed. This is the face of the people that retail pharmacists across our country has to face day in and day out. It's a matter of time before the next one flips out and does the same thing.

Here are three of the four victims. I hope that both of these horrible criminals get exactly what they deserve. However, the accused have more rights than these three victims had killed at point blank range.

A pharmacist, a mom of three getting ready for her wedding, and a lady graduating from high school just days later killed FOR NO REASON. (also not pictured an elderly man was gunned down as well).

 

Generic Drug Company Win

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By a 5-4 vote,  the justices gave a victory to Israel's Teva Pharmaceutical Industries Ltd, Mylan Inc's UDL Laboratories and Iceland-based Actavis Inc by overturning U.S. appeals court rulings that allowed such lawsuits. Liberal Justices Sonia Sotomayor, Ruth Bader Ginsburg, Stephen Breyer and Elena Kagan dissented.

"It was impossible for the manufacturers to comply with both their state-law duty to change the label and their federal law duty to keep the label the same," Justice Thomas wrote in a 20-page opinion.

The high court on Thursday ruled against Gladys Mensing, who had sued PLIVA Inc. and other generic drug manufacturers.

She alleges that taking metoclopramide gave her tardive dyskenesia, but none of the generic drug's manufacturers and distributors made any effort to include warnings on the label.

Generic drug makers say government regulations require them to have the same label on metoclopramide as is on its brand-name equivalent, Reglan. Reglan did not have a warning about tardive dyskinesia. The drug is often taken for heartburn.