fandomsecrets | [ SECRET POST #2819 ]

[ SECRET POST #2819 ]

⌈ Secret Post #2819 ⌋

Warning: Some secrets are NOT worksafe and may contain SPOILERS.

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Flat | Top-Level Comments Only

What exactly are Pharmacists doing when I have to wait an hour? Are they actually doing chemistry and putting drugs together back there?

I think they mostly count out the pills from their giant bottle on the shelf to your little prescription bottle and label it.

I usually only have to wait about 15 mins., I guess I am lucky that my pharmacy isn't busy.

'Count out pills.' Oh aren't you cute. Sadly this is what TV and the news has led most people to believe.

Hey, I did apologize below.

BF is a pharmacist, so I can tell you! :) There's a lot going on behind the counter that isn't obvious. People call in or drop off orders, which all need to be entered into the system if they're new. If there's a complication (prescription expired, doctor's handwriting illegible, doctor has prescribed a dosage that doesn't actually exist, potentially dangerous drug interactions) they need to call the doctor's office and straighten it out, which might mean waiting for a call back. Ditto any insurance issues, because people fail to understand that their insurance determines what they pay for drugs, not the pharmacist.

Techs can fill orders (i.e. count out the pills and package them) but by law they need to be checked by a pharmacist to make sure you're getting the right medication. It depends on the pharmacy and the drug prescribed, but yes, some drugs do need to be compounded by hand because they aren't shelf stable or aren't in high enough demand to make ahead of time. So if someone needs some weird kind of cream for say, a skin condition, sometimes the pharmacist will be back there mixing it up according to what percentage of X drug is needed. That's not common, but it happens. If the pharmacy handles controlled substances (basically, drugs that are higher risk for addiction or complications, such as Oxycontin) there are a bunch of strict procedures and rules to follow in dispensing them, which slows the process down.

Then there's also clinical consultations, which are becoming more of a thing. If you have a question about the drugs you're taking, possible drug interactions, side effects or anything like that, you can ask the pharmacist. It's like a short walk-in doctor's appointment. If your problem is something they can't handle, they'll tell you. Many pharmacists can also administer flu shots, and it's getting close to cold/flu season so business will be pretty busy from now on. That's on top of all the other fiddly little administrative things like keeping track of their inventory (because you do NOT just lose track of drugs, that can land you in some deep shit) and stuff like that.

So you multiply this by how many people have a prescription that needs filled and it adds up quickly. Again, it all depends on the pharmacy and the staff and not all pharmacies have a great staff, but BF decided to become one because he likes helping people. Now that I've drowned you in information, I'll go away now. ;D

That's really interesting actually, especially the making medicines par (even if it's not a huge part) - thanks a bunch!

No problem. :) I wanted to elaborate on the other anon's "they mostly count out the pills from their giant bottle on the shelf to your little prescription bottle and label it" comment, because it's a lot more complicated than that and people don't realize it.

Other anon here - sorry about that.

No worries. It's frustrating to be a customer and not know why it's taking so long, especially when you're not feeling well and need your medication. A pharmacist's job doesn't look particularly hard, and it DOES look like they're just filling bottles. But IME, most of them are really nice people who work a frustrating job that's both customer service AND a lot of weird medical/chemistry/biological knowhow behind the scenes.

Huh. You've taught me much this day. I didn't believe pharmacists just counted pills, but I also wasn't aware they did so many different things! (For instance, I wasn't sure if they ever made drugs by hand, so it's interesting to hear that. Must be a hectic job.)

Thanks!

You're very welcome! I didn't know either until BF went to pharmacy school. It's a bit of a specialization that's more common in hospitals than retail pharmacies, but it's neat. He liked it because it involved chemistry and a little more hands on work than usual. Overall, it does sound pretty hectic, not sure I'd want to do it, tbh.

It sounds like being a pharmacist would never be boring, and I imagine helping people is rewarding, but...yea, it does sound like extremely hard work. Good on him for doing it!

Echoing the above anon's response in that there's actually a lot going on behind the counter, but most people never really see what's happening.

In most cases, pharmacy techs count the medications and prepare everything, but every single prescription has to get verified by the pharmacist before it can leave the pharmacy. This can lead to a back-up, especially when the pharmacist has a bunch of prescriptions that people are waiting for + phone calls from doctors calling in prescriptions (that only the pharmacist can take) + patient consultations + flu shots (this time of year is terrible, and a lot of retail pharmacies are also introducing shingles and pneumonia shots too).

Any narcotics can also have an increased wait time, as the pharmacist is the only person allowed to touch them in a retail setting.

A lot of chain retail pharmacies are increasing the work load while cutting hours, so you might've just been there at a bad time!

And as an aside, there are medications that do have to be mixed (mostly antibiotic suspensions) too.

If you have any other questions, I can answer them to the best of my ability - I'm a pharmacy tech and have worked in both the retail and hospital setting. :)

This is so odd for me, living in Norway our pharmacists basically does none of that, at least not in a regular walk in pharmacy.

It is so odd for me that you actually count medication, I just get a pre made box from a factory and if I don't need to take all the pills it is written on the sticker, and I am supposed to give it back to a pharmacy so they can safely dispose of the rest (but I don't think I have ever had any kind of meds where I haven't been told to take it all or as needed)

I think a TMI comment will go on under this, sorry I just find it interesting how different things are in other parts of the world.

The scripts are either filed electronically or they are a print out with the doctors signature. The pills/creams in pre made boxes and pretty much what the pharmacist does is find the correct box print out the sticker with your name and how to administer the drug and then just explains how you use it. Then again even then accidents happen, my pharmacy had to use a week to figure out what the hell my doctor had prescribed to me because of what turned out to be a typo, but they couldn't figure out what he meant (and the name of the drug he used was the old one, not the new one).

We either pay full price for white scripts, which is for as a rule non chronic medication* or on a blue script where you pay 38% of the full price, or maximum 1000$ for a three months supply. Also they have to (by law) tell you if there is cheaper alternative of the drug, so I pay a whooping 6$ dollars for my migraine meds.

Oh and I learnt something new: These people do not pay anything for any blue script prescribed meds:
People in the lowest pension group, Children under 16, People with a disease that could be spread (Chlamydia, HIV and so on), people with lowered immune systems, those who are at the end of their lives (as in pain meds and such for dying people), or doing their compulsory military service, and people with work damage or who have been damaged in war.

*With the exception of Birth Control for females between 16 and 20, they cover 20$ for a three months supply (which is the price of most Birth Control Pills) or if they are more expensive they take 20$ off. And medication for infertility which is completely covered, with the exception of assisted pregnancy, where you pay 300$ for three months yourself and the rest is covered (well 3 times for each child).

That is so interesting, and extremely different than how we do things! I also find it really cool to see how things like pharmacies work in different parts of the world. :)

Yeah, we hand count all medications in retail because usually they come from large stock bottles (which can be 500 or 1000 count). We also aren't supposed to take back any medication from customers under any circumstance - we tell people to go to the police station or town hall to safely dispose of them. When you get a box from the factory, are all the pills individually packaged? (this is called unit dose, and is much more common in hospital pharmacy than retail)

We have scripts come in electronically/faxed over/phoned in/brought in by customers, and we file all of them physically. It'd make so much more sense to file them electronically like you guys, though.

How does it work in your country for controlled substances/narcotics? For example, here narcotics can only be filled if the customer has a physical hardcopy of the prescription, and we can only fill them 3 days before they're 'supposed' to be due.

And does everyone in your country fall under the blue/white script method of payment?

I'm in the US, so as I'm sure you know - insurance here is chaos. Everyone has different insurance in terms of what they will cover and won't cover. I don't think too many people realize how expensive medications can be without insurance, and tend to complain about their $30 copay.

I remember specifically one instance where I had a customer picking up a $2000 medication for their family member (it was an extremely strong antibiotic for someone who was at end of life, and that price was WITH insurance), and the very next customer was complaining about their $0.30 copay. I mean, seriously?

We do also have a program where people in the lowest pension group get the majority of their scripts covered, but I've found that they can be hard to work with - people have trouble getting their applications through to get put on the insurance, they tend to be very picky in what they will and won't cover, etc.

Birth control is an interesting case here! We recently had the introduction of Obamacare, which basically mandated most insurances to cover birth control. In practice, I have seen many people's prescriptions be completely covered or drop drastically in price. There are still some people that do pay a copay for their birth control, but I think it's a great thing that many more people now have greater access to it.

Sorry for the TMI, not sure how much you know/don't know about our system - if you'd like me to expand on anything let me know!

I am always interested in knowing how stuff works in other parts of the world, so I tend to jump on the chance to discuss it. (weirdly enough this is the second time I discuss this on F!S)

The meds look like this when they are in the pharmacy behind a counter, where we can't go, so they are either in tin foil packets (inside the box) or if they are in bottles they are just 25/50/100 pills in there and then they are sealed in the factory and they stick the sticker (with personal info about usage and such) on the outside of the box.

Medication in what apparently is classified as A and B (anything you could get addicted to) have to be locked in secure lockers when the pharmacy is not manned, is the only rule I could find about how they are stored in the pharmacy. The rules for getting them are pretty strict (and A meds, eh Morphine is one of those are written on different prescription pads and they make sure any doctor don't prescribe too much of it) and Morphine and such you'll have to pay the full price for, with exceptions (chronic pain, cancer and so on), then you have C medication which is anything you have to have a prescription on, but they aren't addictive or especially dangerous, I guess antibiotics goes under that, but I am not sure?

But if you are prescribed a controlled substance like morphine/vicodin and so on, you get whatever amount your doctor has said you need, but maximum a three months supply at the time, I'd imagine. That is what it seems my grandfather has at least? And the three months supply rule is just a general rule for any prescription (except for non chronic medication and sometimes if you try out a new kind of medication for something chronic) it pretty much means you can get three boxes of the medication on the prescription, which if you use it in the "most common" way would mean three months.

But things like my migraine meds comes in a box of 6 and that last for anything between two weeks and over a month, but I still get three refills before I have to go back to my doctor to get a new prescription, or in this instance (and similar ones) calling the doctors office would be enough. And the doctor would just refill it and if it is electronic you can go and get it whenever s/he has pressed send or you might have to pick up the hardcopy version if you live in a city without the computer filling implemented just yet, or if you live far away the doctor will fax the prescription to whichever pharmacy you ask him to.

And yes, scripts are either white or blue (tho they don't have the colour, it is just an expression these days). Socialized medicine is where it's at. which also means that when you have spent 400$ on doctors, shrink, hospital, x-rays and medication and equipment on blue prescriptions you don't pay anything for that for the rest of the year, they even automatically send you the "free card" when you reach that amount and refund you whatever you paid over it.

You show your ID, ask for your meds, they find it in the correct shelf print out the sticker and you just sign your name on an electronic pad, pay whatever the price is (which is the same for everyone) and if your prescription is in paper form it gets stamped, put a sticker on, signed by the pharmacists and either given back to you or they can keep it for you if there are any refills left and you are on your way. Surprising how long the queue can get...

I know more than I'd like to know about medical insurance in America (not a complaint about you explaining stuff, because some of it I didn't know, just a comment), it just seems to be unfair and in a lot of cases just not working like it should be.

Anyway I think I explained it the best I could, I looked at the law and then just googled around a bit to make sure my facts were correct.

Edit: I just noticed, the big white and blue box in the middle, that is one of the types of migraine meds I have (it is a nose spray thing, and I hate it with the passion of a thousand burning suns)

Edited 2014-09-22 21:20 (UTC)

Another pharmacy!tech anon here. (Whose husband happens to be a pharmacist as well.) Just echoing that yes, there's a lot more going on behind that counter than meets the eye.

See if you can get your doctor to send the prescription directly to the pharmacy of your choice. Unless the pharmacy is in the clinic/right next door or you really book it over there right away, your prescription will probably be ready by the time you get a chance to get over there. My regular doctor can send things straight to my neighborhood Walgreens, and when I had a UTI while traveling, the walk-in clinic in the town I was visiting could do the same with the Walgreens in that town. I didn't have to wait in either case except for in the line of other customers at the pharmacy pick-up window.

Otherwise, just plan to drop the prescription order off and come back later.

If it's an automatic refill, call to find out if it's ready before you go.

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[ SECRET POST #2819 ]

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