These answers reflect my experience as a pharmacy technician but some of my claims may not be true in every state.
TL;DR: 1) pharmacies don’t have every medication they need on the shelves all the time. It’s not uncommon for a patient to have to wait a day for an uncommon medication. 2) certain tasks in a pharmacy can only legally be completed by a pharmacist so they make the big bucks and 3) pharmacists are highly specialized doctors. This is another reason they make the big bucks and why they spend so long in school.
How do pharmacies always have the medications in stock? – We don’t but we get shipments from our suppliers daily. Anything that’s common and cheap we keep big bottles in stock and order more when we’re running low. For less common or expensive brand-name medications we either order it only when a new script comes in (the medicine gets filled the next day instead of the day the script was written) or we only keep a single open bottle on the shelf which is leftover from an earlier script. Medications expire so we do our best to make sure the least amount of medicine is expiring on our shelves.
Why do pharmacists make so much? – there are tasks in a pharmacy that only the pharmacist can legally do. Without a pharmacist on site the pharmacy comes to a halt. Any technician can be trained to fetch bottles and use a pill counting machine, but each filled script has to be double-checked by the pharmacist before it can rung out for the patient. There are questions that only the pharmacist is knowledgeable enough to answer. If a patient asks me what they should take if they feel sick after a vaccine, I can’t say “you should take Tylenol or Motrin” because I’m not a trained medical professional but the pharmacist can absolutely say that. I’d have to say “the pharmacist has been recommending Tylenol or Motrin to most patients” because it’s a statement of fact and not my opinion. When we order medications the task is completed by a technician, but any medications classified as CII (C2) by the FDA (drugs with a high potential for abuse: amphetamines, opioids, and the like) require the pharmacist to sign off on the order.
Why do they have to go to school for so long? They’re basically highly specialized doctors who focus on how medications affect the body. They need to understand the human body just as well as doctors do and they need to know how different classes of medications interact with the body, what medications can be dangerous when taken together, and they need to be able to catch doctor’s mistakes. Did you know certain diabetes medications can lead nutrient deficiencies? I didn’t know until I heard the pharmacist explaining it to a patient. Do I know which diabetes medications can lead to nutrient deficiencies? No. I’m not a pharmacist and so I’m not qualified to answer this question.
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