what do pharmacist do anyway? Every time I go to the pharmacy, I see a lineup of people behind the counter doing something I’m sure they’re counting up pills, but did they do anything else?
In: 215
Like you’re five? (Reminder for myself because we have some wordy comments here)
Pharmacists keep patients from getting hurt by the doctor’s mistakes. They fill in the holes in a doctor’s knowledge about medicine. In the BEST situation, they’re the last set of eyes on a good script before it goes to the patient, where they make sure the right medicine is in the bottle. And then they talk to the patient about side effects, what they need to do while taking the medicine, how they know it’s working, and when to go back to the doctor about it, or when to stop taking that medicine if something really bad happens.
And they help patients decide which medicines from the store are safe to take with all their other medicines, or which ones will help them the most with their sickness. Or tell them they need to go to the doctor, and over the counter meds like Tylenol won’t actually fix the problem.
Does that make sense?
US pharmacist here 🙂
When a community pharmacist (the ones you see at a grocery store or a retail pharmacy like CVS or Walgreens) gets a prescription your doctor wrote/called in/faxed/ sent electronically, it sets off a chain of events. First we make sure the that the prescription has all of the information we need to fill it. Then we check to make sure the medication is being used or dosed correctly for a good reason, the directions makes sense, and that it wont harm you (which includes making sure it doesn’t interact with any other meds you might be taking). We also try to see if you insurance covers your medication or if they need more paperwork or a different medication, or if not we can see if there might be a coupon. If any of those steps has an issue, we have most likely have to call the doctor’s office or insurance. This is all before we even put the pills in the bottle! After this, we try to fill the medication, but if we don’t have enough or don’t have the medication in stock – more phone calls (!) to either change the medication, order it for the next day, or transfer it to another pharmacy. Finally, we make sure that we wrote on the label matches is what we gave you in the bottle. Then, when you pick up the medication, we counsel you to make sure you know how to take the medication, let you know any side effects, and answer any questions you might have on the medication your picking up or even any medication question you have. We do this for every prescription that we fill. And that doesn’t include the other things we do! We give vaccines and can make recommendations on which ones you might need, answer questions on meds you can by over-the-counter, follow up with you to see how you’re doing on a new medication and, in some states, we can also prescribe some medications like birth control.
Ex-pharmacist here. I dealt with a lot of drug interactions because that 7 years of university to get into and through pharmacy are thorough and that’s all we take for our profession. We took pharmacology (toxicology), physiology, and anatomy with medical students so we have a thorough understanding of what drugs do to the body, long term effects, teratogenicity, mutagenicity, and interactions.
I will also point out that we have to clarify prescriptions with patients on prescription use. Eat with food, do not mix with alcohol, or foods to avoid. My all time favourite – this was supposed to be inserted not eaten and that’s why your teeth are waxy.
You come to the counter. I am on the phone with a drunk dude who wants the phone number to the grocery store next door. After I instruct him on the virtues of 411, you tell me your doctor was to phone in your prescription to me. Your doctor hasn’t, and you’re unwilling to wait until he does. Being in a generous mood, I call your doctors office and am put on hold for 5 minutes, then informed that your prescription was phoned in to my competitor on the other side of town. Phoning the competitor, I am immediately put on hold for 5 minutes before speaking to a clerk, who puts me back on hold to wait for the pharmacist. Your prescription is then transferred to me, and now I have to get the 2 phone calls that have been put on hold while this was being done. Now I return to the counter to ask if we’ve ever filled prescriptions for you before. For some reason, you think that “for you” means “for your cousin” and you answer my question with a “yes”, whereupon I go the computer and see you are not on file.
The phone rings.
You have left to do something very important, such as browse through the monster truck magazines, and do not hear the three PA announcements requesting that you return to the pharmacy. You return eventually, expecting to pick up the finished prescription…..
The phone rings.
……only to find out that I need to ask your address, phone number, date of birth, if you have any allergies and insurance coverage. You tell me you’re allergic to codeine. Since the prescription is for Vicodin I ask you what exactly codeine did to you when you took it. You say it made your stomach hurt and I roll my eyes and write down “no known allergies” You tell me……
The phone rings.
…..you have insurance and spend the next 5 minutes looking for your card. You give up and expect me to be able to file your claim anyway. I call my competitor and am immediately put on hold. Upon reaching a human, I ask them what insurance they have on file for you. I get the information and file your claim, which is rejected because you changed jobs 6 months ago. An dingus barges his way to the counter to ask where the bread is.
The phone rings.
I inform you that the insurance the other pharmacy has on file for you isn’t working. You produce a card in under 10 seconds that you seemed to be unable to find before. What you were really doing was hoping your old insurance would still work because it had a lower copay. Your new card prominently displays the logo of Nebraska Blue Cross, and although Nebraska Blue cross does in fact handle millions of prescription claims every day, for the group you belong to, the claim should go to a company called Caremark, whose logo is nowhere on the card.
The phone rings.
A lady comes to the counter wanting to know why the cherry flavored antacid works better than the lemon cream flavored antacid. What probably happened is that she had a milder case of heartburn when she took the cherry flavored brand, as they both use the exact same ingredient in the same strength. She will not be satisfied though until I confirm her belief that the cherry flavored brand is the superior product. I file your claim with Caremark, who rejects it because you had a 30 day supply of Vicodin filled 15 days ago at another pharmacy. You swear to me on your mother’s’….
The phone rings.
…….life that you did not have a Vicodin prescription filled recently. I call Caremark and am immediately placed on hold. The most beautiful woman on the planet walks buy and notices not a thing. She has never talked to a pharmacist and never will. Upon reaching a human at Caremark, I am informed that the Vicodin prescription was indeed filled at another of my competitors. When I tell you this, you say you got hydrocodone there, not Vicodin. Another little part of me dies.
The phone rings.
It turns out that a few days after your doctor wrote your last prescription, he told you to take it more frequently, meaning that what Caremark thought was a 30-day supply is indeed a 15 day supply with the new instructions. I call your doctor’s office to confirm this and am immediately placed on hold. I call Caremark to get an override and am immediately placed on hold. My laser printer has a paper jam. It’s time for my tech to go to lunch. Caremark issues the override and your claim goes though. Your insurance saves you 85 cents off the regular price of the prescription.
The phone rings.
At the cash register you sign….
The phone rings.
……the acknowledgement that you received a copy of my HIPAA policy and that I offered the required OBRA counseling for new prescriptions. You remark that you’re glad that your last pharmacist told you you shouldn’t take over the counter Tylenol along with the Vicodin, and that the acetaminophen you’re taking instead seems to be working pretty well. I break the news to you that Tylenol is simply a brand name for acetaminophen and you don’t believe me. You fumble around for 2 minutes looking for your checkbook and spend another 2 minutes making out a check for four dollars and sixty seven cents. You ask why the tablets look different than those you got at the other pharmacy. I explain that they are from a different manufacturer. Tomorrow you’ll be back to tell me they don’t work as well.
Now imagine this wasn’t you at all, but the person who dropped off their prescription three people ahead of you, and you’ll start to have an idea why…..your prescription takes so damn long to fill.
Pharmacist here.
Short answer is doctors make mistakes and many people don’t have the literacy (not just in complicated stuff, in general) to know what they’re taking and how.
We make sure the stuff you get is not only correct for you, but also compatible with your other meds. We also make sure you know what you’re taking and how to take it. We are also stupidly accessible which businesses like but is it’s own bees nest of problems.
If it was as simple as putting pills in a bottle it wouldn’t be a doctorate level degree (now at least) that pays 6 figures (in the US at least). Legally we are the second half of the puzzle if you want medication. A doctor has to write the script and a pharmacist has to fill it, and outside very few circumstances that’s it. It’s the only way.
The pharmacist is basically your last line of defense when considering medications. They know more about drug interactions than most doctors. They also often have to negotiate with insurance companies on behalf of the patient. They have to know pretty much every law regarding medications, insurance, and various other things regarding patient health. It can be expansive.
Then there are the pharmacy techs. The unsung heroes that assist the pharmacist in the day to day grind. They’re the ones that count out pills, fill prescriptions, contact insurance, TRY to contact doctors, verify everything is correct, deal with the (often very bitchy) patients.
Latest Answers