The Pharmacy Chick

Flying the coup in retail

Divorcing myself from the job? Easier said than done.

Filed under: Uncategorized — pharmacychick at 7:07 pm on Tuesday, August 11, 2009

The Pharmacy Chick can be called a lot of things but “ambivalent” about her job has never been one of them.  It seems that no matter what I have been given to do, I throw myself into it with abandon, trying to do the best job I can.  Anybody who has ever done community pharmacy is aware that it doesn’t resemble pharmacy as it was practiced even as few as 10-20 years ago.  Independents ruled the landscape.  Cash was king.  In all of this, I have attempted to keep some “community” in retail pharmacy as it exists now.   At the expense of my sanity, I am learning that it may be a losing battle.

I wanted to be there for my customers. I wanted to be DIFFERENT.  I still want to be that unique and different pharmacist for my customers.  It makes me feel good when I can be of help, and to know that in some way I have made a difference in their lives.  Being a friend to them has always been important to me also.  I want to know their first names, their kids names, what is happening in their lives so that when they come in, we have a sense of community.  “So, how’s that car you are restoring John?”  or “Did you have a good time in Cancun, Joyce?”

These are the the things that draw me to my customers and the flip side of that is that these are the things that draw them to me.  They have come to know me.  They have come to TRUST me.  I never want to let them down.  They want ME to give them their flu shots.  Just today one man came in and wanted to know if we had flu shots yet…he wanted his now because I was here.  If there is an insurance hassle, most know that if I cannot fix it, its likely not fixable.  They believe what I say and I make it my business not to say stuff if I cannot back it up.  What this means is that I exhaust all avenues before I tell somebody that something cannot be done.  I don’t take short cuts and I dont’ blow people off.

What has become apparent is while my customers need and want what I do for them,  the company doesn’t seem to hold value to the things that I do.  I value the relationship, they only value what it costs to do business, the lesser the better.  They claim they want to provide amazing service but their actions do not back up their words.

This “disconnect” has created a difficult situation for me.  I still want to be able to do all the things I have done over the years in exactly the same way, but its becoming impossible to maintain that same kind of intensity with the stresses I have to deal with daily.  Labor cuts, more responsibilties, more corporate crap has all eroded the time I have to do the things I love, and left me doing things I hate.

Take for instance vaccinations:  its the one thing about the job I love.  When we started them 5 years ago, we got all the support we needed.  There was a lot of money to be made and because the suits at corporate hadn’t seen its potential, they didn’t meddle.  Pretty soon, they saw the results and decided to take it over and call it their own.  By doing so, they ruined it.  Just a bunch of shit for brains. (pardon my language). Now they want us to hand out coupons, free samples and other crap with every shot, they want people to just drop in for vaccinations (instead of making appointments) and prostitute it into just another comodity instead of  the procedure that it is.  They advertise it like it was a part of a $4 deal.  They created a 3 inch binder of procedures and rules, and have decided  exactly how much labor I am alotted for doing shots.  They have tried to negotiate contracts with dozens of different insurance companies who all want it submitted their own way adding tons of extra work for billing when all we used to bill CASH or Medicare-B.  As a result, we have had a larger  amount of unpaid claims.

Vaccinations were to set us apart as help us be recognized as the health care professionals we are.  Now, its just another burden to bear.

And it goes on. Recently its all been about audits.  Pages and pages of minutae rules and procedures we have to follow for when our own in-store auditors come to visit.  Its completely Draconian and wastes more time than it should.  I recently had a tech who ended up with 15 minutes of overtime…you’d have thought I had sold C-II’s on the street and been caught.  Therefore instead of making sure customers are taken care of, the techs have become clock watchers for fear they will be written up for OT.

Each week I have a barrage of reports I how have to print, sign, date and file. Reports I’ve never needed, wanted or used, I now have to keep and keep PROPERLY because its an audit point deduction if any are missing. 

And because of the labor deductions, when we go on vacations, we dont have adequate tech support for the relief pharmacists who always require a little extra help.  Last week we had one pharmacist about hyperventilate when she only had one tech from 5 pm to 9pm.  What am I supposed to do? Lets see what happens when she comes back and finds out she gets to work alone from 7-9pm with the new labor cuts in place!

We even got a letter tellling us we aren’t allowed to tell people about the labor redcutions.  Bull sh*t.  Am I supposed to let people think we just became slow imbeciles behind the counter?  No way…they are gonna hear that I have one less full time person helping out now.

More crap: I waited 2 months for a printer replacement..we had to duct tape the printer door shut or it wouldn’t print and it jammed about every 20 sheets.

More crap II:  Gift card offers.. the newest and most profound degrading of our profession.    Need I really say more? 

AND, while we have signs all over the store that says, “fill your prescriptions while you shop”  we are now supposed to request that customers return in 24 hours.  After coddling people with ads and signage telling people they can wait for the past 13 years, I’ll tell you, THIS  is not going over very well. 

 Our own generic program is so lame that corporate claims everybody elses by asserting we will  price match..but only if asked. So care to guess how many times I have to carry completed prescriptions BACK from the cash register to redo for a price match? Yea I need the extra work.

Mr Chick knows I am stressed.  He recently spent a half hour telling me I have taken too much on my shoulders trying to be everything to everybody…and failing.  “The company doesn’t give a shit about you Chick..”  “Its time you realize that”.  “Do what you can do and NOTHING…ELSE…” It was hurtful to hear those words. But he was right. He doesn’t want to hear my woes about work anymore.

The hard part is dealing with that truth and acting upon it.  Can I really back off?  Can I really quit trying to let everybody believe that its all wine and roses behind the counter when its really a few minutes from implosion.

Its a dilemma I don’t have a proper solution for yet.  Being a great pharmacist is a major part of my identity.  I don’t want to be or have ever strived to be a mediocre pharmacist.  While I may not be the most brilliant mind on the planet, I have the gift of relating to people.  I just feel that playing the corporate game is not worth losing my relationships.

And there in lies the dilemma..

I just don’t know.

They keep telling me I must do more with less. 

What they fail to realize is that I not sure I have much “more” left. 

If you lasted to the end of this rather long post, I congratulate you!

16 Comments »

Comment by Jaded Rx Intern

August 11, 2009 @ 9:06 pm

I may be a young-un in the field, but I have seen the changes and the bureaucracy in the profession and it gets irritating.

On the note of OT, I just cannot understand the big hullabaloo. Now, if it were hours upon hours of OT, I can understand their side (one winter I was lucky to get about 30 hours of OT, but another pharmacy needed help, I warned them of the OT and they accepted).

A couple weeks ago, I got a quick talking to because of 1/4 hour of OT. Really? Management is so worried about numbers they don’t look at the most important (in their eyes, at least): $$$. Did the math one day, and the difference between 1/4 of regular pay and 1/4 hour of OT for me at the time was $3.25. But what if that extra 15 minutes in the pharmacy was the difference between keeping and losing a patient to customer service. $3.25 vs. years of filling one person’s prescriptions…

Comment by Brian

August 11, 2009 @ 9:33 pm

I wonder almost everyday what keeps me in school knowing that I will have to deal with this for the rest of my life. I have to get out of retail. I just hope the grass is greener…
We dont want to destroy your faith in pharmacy and humanity with our posts, but be realistic when you choose your practice setting because it gets harder to change the longer you are in it. If you choose retail, then be prepared for everything you read here and these other blogs. If you choose hospital, it will be a different set of challenges but rewarding in a different way. Looking back, I wish I had gone the hospital route. But we don’t get that privilege of seeing the future when we set out on our lives. Good luck to you either way you choose! I’ve interviewed in mail order and LTC and hopefully I’ll get that call soon. But for now….here I am.

Comment by Dr. Grumpy

August 12, 2009 @ 4:58 am

Good post. This shit from the business suits is what is taking all the good things out of healthcare, all the reasons that so many people, including me, got into it.

This is why I am in solo practice. I started out with Humungous Neurology Group, Inc., and got sick of the lady who every month would bring me graphs and charts showing my dollars earned per square foot of office space.

I don’t even run those numbers anymore. And am much happier.

Comment by Flrph

August 12, 2009 @ 6:25 am

I’ve been reading your blog for quite awhile now, and this is the first time that I’ve commented. I must say, that I feel exactly the same as you. It’s like you took this post from my mind. I would swear we work for the same company. Anyway, I’ve only been a pharmacist for six years, and have the same feelings. I’ve considered returning to school to become a md, pa, or rn, just so I can still give patient care without some of the corporate crap pushed on us from non-pharmacists. But really, I love being a pharmacist. I love the unique knowledge that I possess and the interactions I have with patients (at least the positive ones). So, I keep plugging away trying my best, and praying that god can somehow help all of us and straighten out this mess.
Well, thanks for reading and for commenting! I appreciate every reader I have!

Comment by sickofstupidpeople

August 12, 2009 @ 7:39 am

PC, except for the rant about vaccines, I could have written your post myself…
Here’s what I do. I continue the great patient care and provide my patients with that sense of community, not so much for them, but because the family that brings their 13 hour old new baby (the 6th for them, so they no longer worry about going out in public so soon) to see ME brings me enough joy for the day to make up for most, if not all, the other shit I have to go through. If you give in and follow the corpo-rules, then you let go of the most rewarding part of the job. Don’t let them beat you down. I’d rather have some suit talk to me about bad management than have my own conscience tell me I’m a bad pharmacist.
And, tell your best patients to call the corporate office and complain on your behalf. I’ve done it – as they (I had three in one day) took the phone number from me, they each gave me a big hug and told me they knew I was doing my best and that they would at least try to get me some help…

Comment by CharlesWestergard

August 12, 2009 @ 9:31 am

This is not only an issue in the retail environment. I can speak as a former hospital-based pharmacist that while there is a lot of talk about “clinical patient care” this often translates into pure cost savings initiatives. I was once questioned about my (appropriate) recommendation of antibiotic for a patient because it was a bit more expensive that the broad spectrum agent they were inappropriately taking. In the overall picture, the slightly more expensive antibiotic would reduce resistance, be easier to take as an outpatient (thus reducing length-of-stay)and had better coverage for the identified organism. I believe that if you focus on doing the right things for patients, cost saving will follow.

The really sad part of all of this is how efficiency is being squeezed out of people. I have been in a lot of hospitals recently in my current role and am amazed at the state of the pharmacy work environment: printers from the 1980’s, computers and software that can barely keep up, documentation systems still on paper… Improving these conditions would help people work more efficiently so they might have time for the more important patient interactions that truly can have an impact. How much impact?

What if pharmacists had time to fully counsel patients at risk for medication non-adherence? To provide follow up call back services to make sure medications were being taken appropriately? Is there a value here? New England Health Institute says it’s worth $290 BILLION a year. I’ll have a blog post up on this soon. We need to take back our profession… now…

~charles

Comment by Frantic Pharmacist

August 12, 2009 @ 12:26 pm

It helps to know someone else is dealing with this OT crap. My technicians are wide-eyed with terror that they might get a few minutes of overtime and are rushing out the door while the closing tasks get screwed up because everyone’s hurrying. And I’m supposed to give the bum’s rush to a customer who just wants to ask a couple of questions (that’s what I’m supposed to be here for, right?) It just looks really bad. I find myself getting home and worrying that I forgot something or didn’t look at it closely enough.

Comment by RxMomma

August 12, 2009 @ 12:56 pm

Hey… PC, there is a 0.6 FTE opening at my hospital for a staffer…. Email me if you are interested.

Comment by Jade

August 12, 2009 @ 1:51 pm

When this stuff hit too close to home, I got gumption (from I don’t know where–maybe, from fact that I’ve got kids that need to observe a little fire of determination), and went back for further book learning. We never stop learning, but going back to classes helps with the semblance of keeping up with trends.

I’d say, never, ever compromise. Just don’t ever do it! If the boss says such and such and doing that leaves your patient without adequate care, make the correct decision for yourself.

Doing what is right is easy part of decision, but still puzzled about what to do next.

There are plenty of temporary work opportunities out here. Updated education geared me up for it. Hopefully, these online discussions, town forum attendance with health care decision makers, as well as ‘smelling the coffee’ will facilitate needed changes.

Comment by Jade

August 12, 2009 @ 1:52 pm

When this stuff hit too close to home, I got gumption (from I don’t know where–maybe, from fact that I’ve got kids that need to observe a little fire of determination), and went back for further book learning. We never stop learning, but going back to classes helps with the semblance of keeping up with trends.

I’d say, never, ever compromise your patient care. Just don’t ever do it! If the boss says such and such and doing that leaves your patient without adequate care, make the correct decision for yourself.

Doing what is right is easy part of decision, but still puzzled about what to do next.

There are plenty of temporary work opportunities out here. Updated education geared me up for it. Hopefully, these online discussions, town forum attendance with health care decision makers, as well as ‘smelling the coffee’ will facilitate needed changes.

Comment by Kelly

August 12, 2009 @ 4:58 pm

Girl, I first want to comment as a “pharmacy customer”. Please continue to give the personalized service to each customer….I know that I, personally, would rather wait in order to get a prescription filled by someone who I know is concerned about my health…and the health of my family. I use Target pharmacy…and love the fact that I get a phone call asking how me (or a family member) is feeling…if we’ve recently had an antibiotic filled there.

Second, as someone who works for a MD (psychiatrist), I am all about the relational side of medical care. The doctor I work for is in private practice and accepts NO insurance or medicare/medicaid of ANY kind. Still, we have over 400 patients and almost everyone of them will call the office and talk to me like we are old friends. Now, I will say that being a mental health office, we have the convienince of seeing our patients every 4-8 weeks…so, it gives us a better opportunity to know them.

I have also dealt with some of the larger pharmacy chains and am shocked that some of the techs call to get an authorization for a refill and they cannot even pronounce the drug (and I am talking about an easy one….like “Zoloft”). It’s scary. I’ve got so many mistakes….that it’s rather scary.

So, Chick, keep doing your job the way God calls you to do your job! The majority of customers will appreciate the time (and accuracy) you take with each of them! 😀

Comment by Peter

August 13, 2009 @ 11:24 am

I completely feel for you. I don’t want the “soon-to-be” pharmacists out there to get discouraged, but I’ll be frank, even clinically and patient focused positions can devolve. I’ve worked the academic, clinic and community side and they can all suck. In the clinical job, I got tired of the hospital bureaucracy. In the academic position, I got tired of the “publish, research, publish” mantra and getting dumped with teaching and service. In the community setting (specialty pharmacy), I got tired of being lied to by management, endless reports, and corporate BS. That’s why I went back to Canada and started my own clinically-oriented pharmacy. No front shop – just a dispensary, 2 private consultation rooms and a passion for the profession. I’ve started a diabetes service and have gotten about 1-2 referals per week since opening. I’m about to launch and anticoagulation service. I still have a few reports and paperwork – but they’re from me. I have to pay the bills and keep track of the bills I’ve paid. On the whole, starting a practice (I don’t call it a business) from scratch is extremely nerve-racking, but I can start to see the light. People coming to pick up Rx’s are not customers – they’re patients. Other pharmacies and pharmacists aren’t competitors – they’re colleagues. This is the only model of pharmacy that I believe showcases the pharmacists knowledge and skill and financially rewards better patient care. So, there is hope. Don’t lose faith. Patients, nurses and physicians need pharmacists like you, Pharmacychick.

Comment by Karen

August 14, 2009 @ 11:34 pm

I feel your pain. Ever thought of stepping down from management? Staff pharmacists do not have to deal with the corporate beancounters as much. Frankly they couldn’t pay me enough to manage. Hang in there!
Have I? I have been looking for 2 years for a non management position or have considered moving to a float type position. One of the things that keep me where I am is the fact I work 3 and 1/2 miles from home and never touch the freeway. I am not excitied about moving to a giant commute and tho I have interviewed with a couple of different companies outside of retail, they haven’t decided to hire yet…they’re dragging their feet while the economy is still stinking…I’m looking tho…trust me on that one.

Comment by Ozzy West

August 17, 2009 @ 11:03 am

Greetings,

Mr. Chick realizes the truth: The suits regard you as a disposible, interchangeable, expendable widget.

To maintain my composure I have come to regard my employer of the moment as the disposible, interchangeable, expendable source of my most recent paycheck and potentially, but not necessarily, my next.

Oz
Brilliantly said Oz…

Comment by Greenerpastures

November 13, 2009 @ 10:29 pm

PC I can really identify with you right now. I’ve spent a dozen years with the same company in the same town and I can no longer provide the service my patients expect. I work for one of your competitors and it is the exact same BS. 15 minutes of OT is tantamount to stealing. We have so many 1% rules…1% of the Pharmacists don’t do the right thing so here is a new time consuming policy/report/task that you MUST accomplish/acknowledge immediately if not sooner or you will be in trouble. I finally bagged it and am headed for a new job out of retail. I too had forgotten how much I hated interviewing and negotiating. I’m taking a paycut but I’ll be closer to family. My wife has said I already seem happier. I wish you luck.
congrats on getting out of retail!! I keep trying. Since I am not going to trade the frying pan for the fire, I am looking for that RIGHT fit! I completely relate to that 1% rule, same here. I can’t stand one more thing to sign/acknowledge-or-get-your-butt-fired policy change! take care!! PC

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May 4, 2010 @ 6:28 pm

[…] only that, I think I also caught a glimpse of The Pharmacy Chick after a hard day at work too. Don’t let the job get you down PC. […]
Brilliant..and while I have never contemplated suicide per se, there are a lot of people I’d have happily shoved handfuls of sleeping pills into their mouths! Thanks for sharing!!

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