To Post or Not To Post

As I sit here gazing out the library window as the wisps of spring begin to enter the air, I have been contemplating the last few months of my life. They have been a roller coaster of triumph, failure and exhaustion. With the light at the end of the tunnel slowly growing brighter, I am left in a bit of a quandary....

...Namely whether or not I shall continue this blog.

For almost four years and 503 posts I have documented my journey as a discouraged undergrad to successfully adapting to pharmacy curriculum.

I have gotten married, become a father, moved hundreds of miles and lost a good friend along the way. This site was originally designed as a centralized database for my adventures at work, but over the years it has evolved into something more.

Now I am left wondering where to take it from here. I do not have the time, nor the confidence or experience, to take it in the direction of Eric, RPh or The Redheaded Pharmacist. I cannot compete with the artful and hilarious writings of Drug Monkey or TAP. Nor do I want to emulate any other pharmacy blog in existence.

I always told myself that I wanted this site to be something slightly unique and different. Everyone can yell and complain about the profession, I had decided long ago to delve onto a different path.

Today, when I wish to write I find myself writing more about my other main interest rather than pharmacy. I am not sure if it is that I am burnt out on the topic due to the trial and tribulations of the first year of school or if it is something more.

Call it writer's block if you will... except there is no actual block. It's merely a nonchalant feeling when it comes to discussing daily aspects related to the profession.

That, and the pharmacy I work at is incredibly boring to work in.

Earlier this week I toyed with the idea of possibly calling it quits. The response I have received since then has kept me open to the idea of keeping open... at least until I can decompress over the summer.

In short, the tone of this place may change a bit in the coming weeks. As to what that one may be, I cannot say, but it will be different nonetheless.

Whether its for the good or the bad... well that's up to you to let me know.

The Oxycontin OCs: Dedication to Live By

If you haven't received a phone call in the past few weeks of someone asking if you have "any of the Oxycodone tablets with the OCs on it." Then you're probably not working in a pharmacy. It's most likely a Radio Shack. Or maybe a Wendy's.

Probably should check on that.

Earlier this week though, the one OCer took this dedication to a whole new level. This person, for some unknown reason, asked the pharmacist the following question.

"Yea I uh... I threw up a little while ago and uh.... well I threw up my Oxycontin and they're the ones that work with the OC on them and uhhh... is it okay if I take uhh... if I take them again?"

Ya know what, if you're willing to re-ingest your freshly vomited Oxy, you go right ahead. Hell, while you're at it, there might be some left in your shit so why don't you make a sandwich out of that too.

Who says addicts can be dedicated to their trade? I felt like I should give her a freakin' award first for the mental capacity to even come up with such an act, and second for the desire to complete it. It's truly an astounding feat, much like this video.

Actually, I take that back because at least the monkey didn't lick the finger...

Roads... Where We're Going We Won't Need Roads... But We Will Need a Prior Auth

Is there any other rejection phrase I dread more than:

DRUG NOT COVERED; STEP-THERAPY/PA REQUIRED. CALL 1-800-JACKOFF

Seriously, that simple string of words is enough for this normally calm little pharmacy student to erupt in a fury of rage reminiscent of taking a cake away from a fat kid.

What makes it worse is that it happens when you least expect it, eerily similar to a herpes outbreak. Kind of like when someone brought in a new prescription today for loratadine.

"But Phathead," you're saying, "The smidgen of glue that holds the label on the bottle costs more than the number of tablets in the bottle. Never in a million years would a PBM require a PA on it."

Well that would be true... if PBMs were run by human beings with a lick of logic.

This particular plan, cough Medco cough, decided that cetirizine needed to be first line and that, for some god forsaken reason, loratadine would only be paid for after a PA and step-therapy.

Way to go Medco, you just saved yourself a whopping two cents by denying the initial fill. Glory be to you for such a wise financial decision which will ultimately bring troves of riches to your CEO. And by troves, I mean one or two extra Tootise Rolls after lunch.

Long time readers may remember that I have a particular hatred for the sadists that call themselves Medco. If anyone deserves to have bamboo shoots shoved up their urethrae and then forced to watch Glee for 24 hours straight, these guys are the unanimous winners.

After the pharmacist stopped laughing at the ridiculousness of the rejection, we kindly pointed her to the allergy aisle and told her it would only be a few dollars more to bypass this lunacy and receive the same treatment. She agreed, the gray skies parted and for a brief while peace and tranquility returned to the pharmacy.

Until the next PA rejection. About two minutes later.

Damnit.

Rite Aid: Cheapening the Profession $5 at a Time

The majority of us are aware of Rite Aid's guarantee to patients that their prescription will be ready in 15 minutes. For the most part, I don't have a problem with that. I give our guarantee to our patients that if you fill your Norco on time, a Spanish speaking Monkey will fly out of my ass and make you a denver omelet.

See, I can promise things too.

Apparently, this wasn't enough. Oh no, in an age where a Dateline special lurks around the corner for a worn down, exhausted pharmacist to make a mistake, Rite Aid decided to kick it up a notch. They decided to offer a $5 gift card if that 15 minute guarantee is not met.

Bravo Rite Aid, bravo. Way to aim yet another shotgun blast to the image of pharmacy.

We live in a world where pharmacy is viewed as a product based business rather than the service it truly is. That's how PBMs reimburse us, that's how the public views us and that's how we are treated on a daily basis. If we are to truly reach the goals laid out by APhA and other organizations, we must truly remedy this fallacy.

But then there is Rite Aid, making sure that for every step forward that we are shoved back another five.

A few weeks ago I questioned why national organization such as APhA did not denounce WAG's creation of Wal-beer. Again, I ask, how can APhA allow such a cheap attempt to attain customers without disparage?

It doesn't so much matter that the 15 minute guarantee is a game of Russian Roulette as it is. Rite Aid just made sure that the barrel is loaded with five bullets instead of just one.

Rarely are we complemented for the work we do in fixing errors by doctors, solving various insurance issues, keep track of interactions or offering simple advice. We are chastised when their doctor takes one day too long to fax back a refill authorization or when the four different C-IIs they drop off take a bit too long to fill.

The public already treats us like we're the bitch of the health care system, there's no need to give them another whip to play with.

People need to start realizing that in pharmacy the customer is not always right. In fact, they are not a customer at all, they are a patient and we are a health care provider. This is not a Jiffy Lube where we'll top off the washer fluid just for the hell of it.

And with ridiculous programs like the one Rite Aid is employing, we'll have a damn hard time trying to convince anyone otherwise.

It's just too bad they can't use their $5 to buy a six pack of Wal-Beer. Oh wait, I think I just gave someone an idea...

Hello Reality

This semester we have moved past the regurgitation of pre-reqs and are slowly delving into actual pharmacy material. It has been an enjoyable experience, for the most part, to start learning the information that I have been aching to yearn for several years.

Suddenly last night I was introduced to a small bit of reality. In discussing a question from our most recent drug delivery exam, one of the people in our group exclaimed it didn't matter if he didn't understand a particular type of question because it was just one exam.

I thought about that statement later that night, and about the question in general, and came to a startling dose of reality.

What we learn now truly does matter.

When you're an undergrad sitting in philosophy or British lit, you realize that what you are learning is really immaterial to your future. Sure it's good to learn about Socrates and maybe you can apply some of those learnings to your daily life.

In reality it does not matter if you remember who did what and a certain act. Call it disposable knowledge if you will.

Last night came the realization that, for the most part, that disposable knowledge is now gone.

The question the person in our group claimed to not care if he understood had to do with renal clearance for certain drugs. It's a piece of information that, may very well, prove to be highly important at some point in your professional life.

What we are learning now is the opposite of disposable knowledge, it is highly intrinsic knowledge that we will in some form be using for the rest of our professional lives.

It may seem like a meek or unimportant realization, but it's a stark one nonetheless. That thought provided the first feeling that this was more than just exams and labs... that we were actually learning something with a purpose.

And it was a pretty damn good feeling.