Current Events > Retail pharmacy is the worst example of healthcare as a business

(+) Yeah! (+)

hockeybub89 posted...

It's not always things that literally cost the patient money, but basically every prescription possible is expected to be a 90 day supply on automatic refill that is proactively requested from the doctor every single time refills run out. And if you can't convince a patient to do that, then you are clearly not saying the right combination of words and there is no other explanation. I've seen my pharmacist catch shit because not enough patients picked up the phone during our weekly patient calls. How do you make someone answer the phone?

You are a salesman first and anything else a distant second. That person would have said yes to that anal cream for their hemorrhoids that cleared up 4 months ago if you sold it better, without sounding like you're selling anything.

Okay that makes sense then

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Gakk86 posted...

Yeah, the problem is totally me, it's not like I'm doing exactly what my company demands or anything. Hell, my performance has me transitioning into training other people to do what I do (and get paid a lot more, thankfully).

Why dont you go do something else? Im not even joking. If youre at the point where youre doing unethical acts and you clearly hate being there, then change your life. Trust me, I got mad and defensive when someone else told me the same thing years ago. But you know what? He was right. He was tired of hearing me complain like a little bitch about a job that was slowly breaking me down. Well, like a month later, I was out of there. The transition was not easy, but I saved my mental health and nobody else has to deal with me yapping about it anymore.

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tote_all posted...

@Gakk86 you're literally a scammer that admitted he has no ethics. You're lost a low-earning scammer. We're not gonna feel sorry for you "being a victim of the system".

@NightingaleMD please explain what you meant, I'm curious if you think it applies to all doctors.

I'm a "low earning". You're an elitist boot licking piece of shit, go suck off Trump you fucking loser.

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Lorenzo_2003 posted...

Why dont you go do something else? Im not even joking. If youre at the point where youre doing unethical acts and you clearly hate being there, then change your life. Trust me, I got mad and defensive when someone else told me the same thing years ago. But you know what? He was right. He was tired of hearing me complain like a little bitch about a job that was slowly breaking me down. Well, like a month later, I was out of there. The transition was not easy, but I saved my mental health and nobody else has to deal with me yapping about it anymore.

This is my 3rd career. I made a change to get here. But please, blame me for the industry I work in. Obviously it's all my fault.

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Just following orders isn't really an excuse. Everyone is ultimately responsible for their own actions and deliberately doing things you know are wrong or illegal makes you a bad person.

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uwnim posted...

Just following orders isn't really an excuse. Everyone is ultimately responsible for their own actions and deliberately doing things you know are wrong or illegal makes you a bad person.

I have done nothing illegal, don't be a fool. The laws are made by the government, and these corporations are the government. Pressing a button on a register is not illegal, for fuck's sake.

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Gakk86 posted...

I have done nothing illegal, don't be a fool. The laws are made by the government, and these corporations are the government. Pressing a button on a register is not illegal, for fuck's sake.

Gakk86 posted...

Sign people up for programs they wouldn't be interested in and cost them money without asking?

This is illegal.

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uwnim posted...

This is illegal.

Really. What law?

Look, I get what you're saying. Corporations taking advantage of people like that is disgusting, and should be illegal. But it isn't, and in fact is the basis of many industries.

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I worked at one for a few years until very recently. There is so much I can say about what made it terrible. So stressful for everyone, the workers & management. Wed be short staffed at the front & pharmacy (which would constantly be calling for more help). And corporate would just cut more hours.

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tote_all posted...

@Gakk86 you're literally a scammer that admitted he has no ethics. You're lost a low-earning scammer. We're not gonna feel sorry for you "being a victim of the system".

@NightingaleMD please explain what you meant, I'm curious if you think it applies to all doctors.

my god is not patient care

my god is metrics from my overlords

this is modern medicine

I spend in an 8 hour shift 6 hours at my computer charting/documenting and maybe 2 hours of actually seeing patients or doing procedures

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Pharmacy is bad in general, lack of respect from other healthcare professionals, extremely saturated, projected 0% job growth, etc.

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Ive heard a lot of the same things a lot of people on here have mentioned regarding how Chain pharmacies are extremely metric based. Im thankful that Ive never worked at a pharmacy like that. My first job was at a small town independent pharmacy and my second and current job is at a local hospital Retail pharmacy.

While we arent pushed for metrics, we definitely see some of the negative things of healthcare. The biggest thing which Im surprised hasnt been discussed in depth in this topic is insurance. Not just billing and handling it, but dealing with how scummy they are, both for the patient and the pharmacist. Insurances have such crazy restrictions, are so hard to get ahold of, sometimes ignore basic logic (workers comp insurance once rejected HIV meds for an exposure patient and said it may take a week to get it approved.....), insurance always trying to force patients to their mail order through scummy practices to the retail stores, and even scummier is most insurances reimburse pharmacies so abysmally I dont understand how some can stay in business.

So much shady stuff, yet we cant do Dick about it. And worst of all is when you see all these people understand so little about their own insurance. Medicare Part D people especially. Is this completely lack of understanding societys fault or insurance trying to be complicated as possible to profit off the confusion?

sorry for the rambling rant. I just think insurance is the root cause of a lot of healthcares issues, yet we never seem to discuss it as much as we should.

Speaking of insurance, we had those new FDA guidelines on insulin packaging dropped on us and it's like "Oh you can't break boxes anymore. Call the patient's plan if there's an issue and figure it out." So you get patients running out of insulin while we contact their doctors for new prescriptions written for at least a box worth. Or their plan only covers 30 days and a whole box is like 120 days worth and you have to figure out how to get the insurance to ok it. Insurance is bullshit enough on a good day.

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My old store didnt break boxes of insulin and if a patient ever had a greater day supply than their insurance would allow, wed bill the full box for The max day supply and leave a note saying day supply per insurance, cannot break box.

Im assuming that wouldnt fly on an audit; but thats what our manager had us do.

BroodRyu posted...

My old store didnt break boxes of insulin and if a patient ever had a greater day supply than their insurance would allow, wed bill the full box for The max day supply and leave a note saying day supply per insurance, cannot break box.

Im assuming that wouldnt fly on an audit; but thats what our manager had us do.

We've always done that with some drugs and that's basically all we've been able to do for insulin now. If the insurance companies haven't adjusted their policies yet, a single pharmacy tech on the phone isn't going to be able to change that. It's not like the rep on the phone has any idea what to do.

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Pharmacy is so metrics based that pharmacists are scummy af

Saw a pharmacist tell their techs to basically give a patient the runaround to pay through their insurance rather than accepting GoodRX

Basically said, oh it's already covered by GoodRx (when it really is under their insurance price)
Oh, GoodRX isn't working, etc.. until they ask like 3 times then they'll let it go through

Tryhaptaward posted...

Pharmacy is so metrics based that pharmacists are scummy af

Saw a pharmacist tell their techs to basically give a patient the runaround to pay through their insurance rather than accepting GoodRX

Basically said, oh it's already covered by GoodRx (when it really is under their insurance price)
Oh, GoodRX isn't working, etc.. until they ask like 3 times then they'll let it go through

Like I said, this is why our pharmacy gets crapped on as a bad store because we're staffed by people with consciences that can't buy in to corporate's mindset. Pretty much everyone has said that if they leave the store, then it will be to a job outside the company.

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Another issue is that most pharmacies here dont accept GoodRx unless theyre a CVS or Walgreens because of how poor the reimbursement supposedly is through Goodrx. You gotta remember that since the US makes healthcare a business for profit, a lot of pharmacies cannot afford to sell all their prescriptions at a loss. What other business model would this fly? Its a fundamental flaw in our government. But it never changes.

Gakk86 posted...

Really. What law?

Look, I get what you're saying. Corporations taking advantage of people like that is disgusting, and should be illegal. But it isn't, and in fact is the basis of many industries.

Wasn't Wells Fargo (the bank) literally ****** when it was revealed that employees were opening accounts under people's names without their knowledge/permission?

Bump because Id like to see more discussion on this topic.

Looks like this year, every store is expected to do double the flu shots that they did last year. They want about 10 an hour, but are only providing an extra pharmacist dedicated to giving shots 4 hours a day Monday thru Friday. Somehow, pharmacists are supposed to find the the time to do this on top of everything else. At least they still get 0 minutes of break per day.

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I can tell you this...there's like no consistency with how pharmacies operate, at least in my experience. One month they'll fill with my RX with one brand, the next month a different one, and sometimes they'll use discount cards, and other times they'll bill it through my insurance which is more expensive.

Maybe it's an issue with availability and brands, but I do know that one time one pharmacy worker said all they could was one that was going to cost me over $100, because they didn't have generic available. Then an hour later the pharmacy manager called and said they actually did have generic, just not the exact same generic I had gotten last time, which is why they didn't offer it to me before. So they filled it up...and then when I got down there and inspected, I realized that they gave me the kind of generic that I *had* received before. And either way, considering I have always told them every single time "I don't care if it's generic. It works the same. I want what's cheapest", I don't see why filling up ONE prescription for me needs to be a big mess with phone calls every other time it gets filled.

And as I say all that, I'm perfectly aware that these issues are probably not 100% the fault of the retail employees. The infrastructure given to them by corporate, staffing limitations, all the laws that dictate how billing and filling and shit works, etc.

YellowMustard69 posted...

I can tell you this...there's like no consistency with how pharmacies operate, at least in my experience. One month they'll fill with my RX with one brand, the next month a different one, and sometimes they'll use discount cards, and other times they'll bill it through my insurance which is more expensive.

Maybe it's an issue with availability and brands, but I do know that one time one pharmacy worker said all they could was one that was going to cost me over $100, because they didn't have generic available. Then an hour later the pharmacy manager called and said they actually did have generic, just not the exact same generic I had gotten last time, which is why they didn't offer it to me before. So they filled it up...and then when I got down there and inspected, I realized that they gave me the kind of generic that I *had* received before. And either way, considering I have always told them every single time "I don't care if it's generic. It works the same. I want what's cheapest", I don't see why filling up ONE prescription for me needs to be a big mess with phone calls every other time it gets filled.

And as I say all that, I'm perfectly aware that these issues are probably not 100% the fault of the retail employees. The infrastructure given to them by corporate, staffing limitations, all the laws that dictate how billing and filling and shit works, etc.

That kinda just sounds like incompetence at the store level. They shouldn't be just changing you to a not covered name brand without telling you. There is no reason they couldn't just swap you to another generic manufacturer if they can get that. It literally costs the same unless you have some really wacky insurance.

What drug was it?

*Edit: You said discount cards are cheaper. In that case, the system can sometimes mess that up. It doesn't always know how a prescription was last filled and insurance plans are prioritized over discounts because they're programmed with the assumption that insurance would be cheaper. A employer unfamiliar with you could easily not know how you want it, though it wouldn't hurt to actually make an effort.

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tote_all posted...

Sucks that you have a shitty job then. Sorry to hear that.

It's not "my job" @tote_all , it's how all of medicine is run

If you want to be a doctor in this country this is how you do it

I can't quit this job and go somewhere else expecting a different result

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NightingaleMD posted...

It's not "my job" @tote_all , it's how all of medicine is run

If you want to be a doctor in this country this is how you do it

I can't quit this job and go somewhere else expecting a different result

You can just move to another country or run for government and personally spearhead systematic change. Stop making excuses, bro!

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Ive worked in retail pharmacy for about 8 years and plan on continuing to be in retail pharmacy when I finish up my PharmD next spring unless I can do something clinical without pursuing a PGY1 (which is mostly impossible in the current climate) because I currently have no plans to do so.

Its pretty bad and its only gotten progressively worse over the last decade or so

Sexypwnstar posted...

Pharmacy is bad in general, lack of respect from other healthcare professionals, extremely saturated, projected 0% job growth, etc.

Clinical pharmacists tend to be able to throw their weight around more at their practice site because physicians get to see first hand how they save their dumbasses. Retail pharmacists tend to get the shaft more in that regard

like this week I had to play phone tag because a physician sent in a dose of a medication that was way too high for their body weight and basically got told after several hours I was a moron until I talked to another physician in the same office who finally helped me get through to the prescribing physician that it was going to cause much more harm than good

as for job growth

Yeah its pretty bad. When I committed the outlook was great but declining. Now Im probably going to have to settle for not even full time at a much reduced pay compared to what classes before me were making when coming out because they know theres a metric ton of us looking for jobs

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I work in a long-term care pharmacy owned by CVS. We are a large facility, we give shipments to courier drivers to take to senior homes and rehab centers. The pandemic caused out business to go from 4000-5000 scripts a day to 1400-1800 a day. CVS is a truly awful, evil company.

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NightingaleMD posted...

It's not "my job" @tote_all , it's how all of medicine is run

If you want to be a doctor in this country this is how you do it

I can't quit this job and go somewhere else expecting a different result

What specialty are you in? I ask because I have friends/family in different fields, and most seem to have a lot more client contact than 20%

hockeybub89 posted...

You can just move to another country or run for government and personally spearhead systematic change. Stop making excuses, bro!

Other countries pay their doctors more than 50% less

no thanks

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tote_all posted...

lmfao

There it is.

Out of curiosity where do you practice

your posts make it sound like its not the US

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DezDroppedFreak posted...

Ive worked in retail pharmacy for about 8 years and plan on continuing to be in retail pharmacy when I finish up my PharmD next spring unless I can do something clinical without pursuing a PGY1 (which is mostly impossible in the current climate) because I currently have no plans to do so.

Its pretty bad and its only gotten progressively worse over the last decade or so

Clinical pharmacists tend to be able to throw their weight around more at their practice site because physicians get to see first hand how they save their dumbasses. Retail pharmacists tend to get the shaft more in that regard

like this week I had to play phone tag because a physician sent in a dose of a medication that was way too high for their body weight and basically got told after several hours I was a moron until I talked to another physician in the same office who finally helped me get through to the prescribing physician that it was going to cause much more harm than good

as for job growth

Yeah its pretty bad. When I committed the outlook was great but declining. Now Im probably going to have to settle for not even full time at a much reduced pay compared to what classes before me were making when coming out because they know theres a metric ton of us looking for jobs

Good luck, hate that this profession and the bodies that represent it basically have no spine. So saturated and new schools are still opening and it's a breeze to even get into pharmacy school now.

All the pharmacists I work with in a hospital setting actually don't have residencies and some are recent grads in the past 2-4 years, but they were mostly just lucky in the right place and right time for openings, but even then they have like 1-2 other per diem gigs at other hospitals to pay off that debt...

If only industry wasn't so hard to get into...

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I know this is off topic but kinda related my family Doctor would charge $65.00 a visit, my insurance was just charged $115.00 by him for a skype call just to refill my blood pressure medicine and it took all of 5 mins.

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Dat_Cracka_Jax posted...

What do you mean? I've never been sold anything that wasn't my prescription at a pharmacy

Like the other guy explained, its more so convincing people to sign up or receive different programs or services. Were pressured to try and sell every single person on immunizations, get them to refill whatever prescriptions they can, sign them up for automatic refills/med sync/prescription savings programs, and we have to make literal telemarketing calls to a daily list of patients that the company has identified are prime candidates to receive these services. Nowhere in the metrics is there anything about actually making sure peoples medication regimen is appropriate for them. If it doesnt kill the patient, its basically ok.

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Sexypwnstar posted...

So saturated and new schools are still opening and it's a breeze to even get into pharmacy school now.

Its insane. My school started offering a new program for high school seniors/college freshmen where if they commit to go there after they finish their pre-requisites and finish them with I think a 3.5 theyre guaranteed a spot and dont have to take the PCAT. I think they see the writing on the wall and are trying to get their claws into kids now

Sexypwnstar posted...

All the pharmacists I work with in a hospital setting actually don't have residencies and some are recent grads in the past 2-4 years, but they were mostly just lucky in the right place and right time for openings, but even then they have like 1-2 other per diem gigs at other hospitals to pay off that debt...

that gives me a little hope about having more possible options at least if I dont do a residency, but I feel like thats the current trend for the clinical side

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I've been asked if I wanted to sign up for their programs and whatever fluff, but never once have they ever automatically charged me for it

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tote_all posted...

Yeah but no capitalism is great free market regulates itself man fuck yeah money.

every time my district manager says something on a conference call about crushing it with sales I have to fight back the urge to bring up all the people who turned down their medication because they couldnt afford it. healthcare should absolutely not be for profit. Id be willing to cut my salary in half if it meant a more equitable system (provided something could be done about my mountain of student loans).

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[LFAQs-redacted-quote]


sorry

Are you implying I should go work at some mountain sherpa clinic in nepal for 15 cents a week? You're more than welcome to spend 4 years of undergrad+4 years med school+3 years of residency to go do that.

Though, until you're in my position, not sure where the lmfa comes from. There's nothing wrong with wanting to be rewarded for high skills that take years to hone and have intrinsic value. I didn't design this broken system, I just work in it. It also pays for nice things.

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"The flu shot target was 800 this weekend and the district only got 120"

Maybe because flu season didn't start yet and corporate's goals are literally impossible.

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Corporate goals not based on reality should just be ignored, tbh.

NightingaleMD posted...

sorry

Are you implying I should go work at some mountain sherpa clinic in nepal for 15 cents a week? You're more than welcome to spend 4 years of undergrad+4 years med school+3 years of residency to go do that.

Though, until you're in my position, not sure where the lmfa comes from. There's nothing wrong with wanting to be rewarded for high skills that take years to hone and have intrinsic value. I didn't design this broken system, I just work in it. It also pays for nice things.

Tbh, you shouldnt have to have 4 years of undergrad. It is a waste of time and money that has no real connection to your career. Like you should have been able to go straight to a med school and only study stuff that is actually relevant.

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hockeybub89 posted...

"The flu shot target was 800 this weekend and the district only got 120"

Maybe because flu season didn't start yet and corporate's goals are literally impossible.

We were expected to do 200 over the weekend but only got 100 in stock for the week LOL.

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