A Day in the Life of a Retail Pharmacist
Thinking about becoming a pharmacist? Don't worry about it. They make some really good drugs for that, and with years of counseling, there is still some hope for you. Many people wonder what we actually do. You have come to the right place. I have been doing retail pharmacy for nearly 20 years. I started as a technician typing out prescription labels on a typewriter. For those of you who do not know what a typewriter is...look it up. You had to hit the keys hard because we only typed on stone tablets way back then! I'm going to explain what we, as retail pharmacist's do.
Okay, so what do we do? First of all, by a "retail" pharmacist I mean the pharmacist (or druggist, or pill pusher, or whatever you prefer) who is typically working behind that long counter at your neighborhood CVS, Walgreens, Rite Aid, etc. The raised platform we stand on has nothing to do with a superiority complex. We aren't better than you. But we do need to be able to see what the teenager in the family planning aisle is trying to stuff in his coat pocket. You can also usually identify us by the white coat they make us wear (which is usually covered in stains from cough syrup, printer toner, and that meatball grinder I had to eat while standing up). We have chosen to work in retail, rather than in a hospital or other clinical setting because of a mild form of insanity for which shock therapy has not yet been successful. Yes, you can start feeling bad for us now.
HOW HARD IS PHARMACY SCHOOL?
One question I tend to get asked a lot is: How hard is pharmacy school?
That is a good question. Unfortunately there is no single answer that would apply to every person. I can tell you that personally I found Calculus (a class needed prior to pharmacy school) to be harder than pharmacy school itself.
How hard pharmacy school is will depend a lot on how easily science comes for you and on your ability to memorize. Feel free to ask me any specific questions you may have.
We went to school (go Huskies!). I know it doesn't seem like it, but we did. And it wasn't easy. Sleepless nights spent memorizing the pharmacokinetics of fluoxetine, the chemical structure of Klonopin, the 32 million drug interactions for Warfarin, the innumerable side of effects of virtually every drug we dispense, and, oh yeah, learning why you never, never, never want to overdose with Acetaminophen. Not pretty. Anyway, back to my point, we did go to school. Today pharmacy students typically graduate with what is called a PharmD. It takes 6 years to get it, unless you enroll in one of several accelerated suicide programs (like the one at which I taught for a couple years).
So what do we do? To put it very simply: We...
(1) prepare the medication for you...and then
(2) we prepare you for the medicine (or try to at least...).
That's over-simplified...but it moves us in the right direction.
Preparing the Medicine for You
Now, for the most part, we aren't "compounding" the medicine from scratch. We know how, and we could, but it isn't necessary too often any more. Although I have created some pretty cool compounds for kittens, tonics for turtles, and a variety of other concoctions for some curious critters. We compound for people too. But really, for the most part, we are overseeing the process which involves:
1) Properly interpreting your prescription. Yeah, that's no picnic. Ever tried to read one yourself? That is why pharmacists are the most trusted profession. You have to trust us...no one else can read your doctor's handwriting! Apologies to any MD's reading this! But really, this is critical. While doing this we are assessing if the dose seems appropriate for the patient. People make mistakes, and so we are a "double check" on the system to try to ensure you get a safe dose of the right drug.
2) Evaluating your prescription in the light of your other medication or conditions. The fancy little term for this is DUR (Drug Utilization Review). If this is the only drug you have ever taken....thank you! My job just got easier. But now its time to wake up and smell the coffee! The fact is most people are on several medications (or OTC drugs) from their doctor. Not to mention the fact that they got 1 from their general practitioner, 1 from their heart specialist, 2 from their endocrine doctor, another from the surgeon, and now 1 more from the ER doctor they just saw. Do you think all of the doctors get together over coffee at Starbucks and discuss if the meds they are prescribing for you are going to agree with each other? "What's that Doug? You gave her clarithromycin? Yeah, that'll be fine with the indomethacin I have her on. Now could you pass the sugar?" I don't think so. Sure, hopefully they ask what you have been taking, but maybe you forgot something or maybe they might be just a little bit busy and neglect to check the chart. Whatever the case, the pharmacist is responsible to ensure there are no significant drug interactions between medications you are currently taking. So, please, please, please try to get all of your medications filled at 1 pharmacy. If you do get something elsewhere, make sure you let your pharmacy know before filling a new prescription.
While I am on the subject, can I ask one other small favor? Please don't get mad when we ask for your date of birth (D.O.B.) when you drop off your prescription. We want to write it on the face of the prescription for a reason. We are trying to ensure we are putting this drug in the right patient's profile. We could look it up...but that defeats the purpose. If we hear it from you, then when we look it up we can MATCH it to the D.O.B. in our system. Imagine if we can't quite read your name on the script, OR imagine if another patient might just have a name similar to or identical to yours. If we put it under the wrong name, and that patient happens to come in to pick up something else, they could potentially end up with your medicine! That is very, very bad.
3) Verifying the final accuracy of the product. Thankfully...did you hear that all you wonderful pharmacy techs...thankfully we have some really great techniciansthese days who handle much of the actual counting, filling, labeling, answering phones, shredding confidential paperwork....I could go on. But before any medicine leaves the pharmacy your friendly neighborhood pharmacist must give it one final blessing. We ensure proper labeling, verify the directions, add any precautionary statements, include relevant paperwork, and a partridge in a pear tree. Ignore the pear tree joke, the fact is we actually take this very seriously.
Preparing You for Your Medicine
This is the fun part. Not that double counting your Oxycontin isn't thrilling; but really, it loses the excitement after a week or two. The fun part of this job for me is communication. I like to talk and I like to teach. So counseling my customers on how to get the most out of their medicine is what really puts the enteric coating on my tablets...so to speak. Of course, the real challenge is to do this with a phone attached to my left ear, a prescription pad in my right hand, a customer asking me which aisle has the Cocoa Puffs, and a store manager reminding me to turn in my payroll figures for the week. Insanity? Yeah...but I love it. So be sure to ask us your questions...I'll be right with you once I finish un-jamming the paper shredder with my pocket knife (yeah...I really tried that...it was a bad day).
IMPORTANT WEBSITES
If you are interested in applying to a pharmacy school, there are several websites that you need to acquaint yourself with. Go to these sites and begin to read and explore them. They contain a large amount of very important and relevant information about applying to pharmacy schools.
10 OTHER THINGS I DID TODAY (Just for fun):
1) 15 minutes on the phone with an insurance company explaining that Mrs. Smith's ferret really did eat her antidepressant pills, and that is why she needs them filled early. By the way, the ferret was fine...happier than ever.
2) 20 total minutes of phone calls trying to track down when and where a particular drug-abusing customer got their last narcotic prescription. Then calling the prescriber back and informing the office that they were just the latest stop on this guys shopping trip. Cancelling the prescription, and then enjoying the moment when I tell them exactly where and when they got their last prescription filled (which they neglected to tell me about). I love the "deer in the headlights" look while they are thinking "how did he find that out???". My little secret. I could tell you, but then I would have to...well...you know.
3) Explaining to a well-meaning but misinformed customer that generic drugs really aren't just brand name drugs that people have returned or that have been collected from the deceased.
4) Patiently trying to help Mr. Jones understand that just because he is going to be taking his prescription for life...it can still run out of refills and needs to be authorized by his doctor.
5) Tracking down and transferring back a prescription for a customer who initially filled her prescription here, but then transferred it out to a pharmacy in Florida, who informed me that it was subsequently transferred to Colorado, which then I discover was cancelled and transferred to a pharmacy in Connecticut, who informed me that she actually has run out of refills. Ugghh. I should have just called the doctor to begin with...
6) Trying to explain to a new customer why we really need their insurance card, and the fact that it is "Blue Cross...or something like that...and I pay $5.00" really isn't quite enough information to go on.
7) Looking through a customer's profile that needs me to refill his "small, sort of yellow looking pill that he takes in the morning with his eggs and toast".
8) Explaining, for maybe the 20th time today, why we have to get a signature when the prescription is picked up, why it took 20 minutes since "we just have to put the pills in a bottle", and that I really don't know why they are out of ‘tickle-me-elmo's'.
9) Telling a hospital resident that, yeah, you can't really put 10 refills on a Percocet prescription.
10) Sympathizing with my complaining technician about the fact that she is the only one who does any work around this place, the other techs all being too lazy to file the scripts from the night before.
Okay...so if you still want to be a pharmacist...awesome! I wish you all the best. It is a rewarding and challenging career. It will often drive you crazy...and I wouldn't have it any other way.