20/20 show on prescription errors...airs FRIDAY

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In Colorado, for every one pharmacist there can be:

1) 3 techs if one of the techs is certified
2) 2 interns
3) 2 interns and one tech
4) 1 intern and 2 techs
 
I was working at a pharmacy yesterday(not Walgreens) and a customer came up to me and told me if I watched 20/20 on Prescription Errors. She told me how she is now scared to go to Walgreens. I just stood there, feeling sorry for Walgreens because of this one 20/20 show. It goes to show how fear plays into people's mind.
 
dumbguy said:
I was working at a pharmacy yesterday(not Walgreens) and a customer came up to me and told me if I watched 20/20 on Prescription Errors. She told me how she is now scared to go to Walgreens. I just stood there, feeling sorry for Walgreens because of this one 20/20 show. It goes to show how fear plays into people's mind.
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That is great news for anti-walgreens folks like me! I hope that there are more news like this around the US.
 
MountainPharmD said:
Colorado has a 1:3 pharmacist to tech ratio with no limit on "ancillary personnel". When I worked for Walgreens I rountinly worked by myself with five or more technicians.
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Mountain - I'm curious - why did you work over the limit?
 
uscfan209 said:
That is great news for anti-walgreens folks like me! I hope that there are more news like this around the US.
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Why are you anti-Walgreens? Are they worse than any other national chain?
 
pion said:
Why are you anti-Walgreens? Are they worse than any other national chain?
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Based on my experience CVS and Walgreens are the worst places to work as a Pharmacist. Go ahead and take the fat bonus and see for yourself what its like to work as an indentured servent.
 
I didnt watch the show, but the comments from many patients this week have me so aggrivated. Ive had countless patients tell me they refuse to sign the book because it "removes all of their rights."

WTF does that mean?

Not to mention comments about how technicians shouldnt be filling Rxs and verifying them. Again, WTF?

Just from reading the comments posted by a few members about how the pharmacists were made to look like fools really says alot about 20/20.

That show is notorious for being one sided and inaccurate.
 
MountainPharmD said:
Based on my experience CVS and Walgreens are the worst places to work as a Pharmacist. Go ahead and take the fat bonus and see for yourself what its like to work as an indentured servent.
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I dont know why everyone says its so bad.

I got an easy store thats 5 minutes from my house, plenty of decent help, 3 or 4 weeks vacation, and a ton of money. I only signed for a year.

Im enjoying my fat bonus quite nicely.
 
StallionRx said:
I dont know why everyone says its so bad.

I got an easy store thats 5 minutes from my house, plenty of decent help, 3 or 4 weeks vacation, and a ton of money. I only signed for a year.

Im enjoying my fat bonus quite nicely.
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You are an exception to the rule my friend. 99% of new grads will sign a bonus for a least three years and get stuck in the float pool for most of that time. They will be totally at the mercy of the DM because he knows you won't quit since you would have to pay that big bonus back. Trust me its a frustrating way to live.

There is always an exception and you are no different. I know a girl who signed on with K-mart of all places. She signed a two year commitment for $56.00 an hour, a $15,000 sign on bonus and 4 weeks of vacation starting on day one. Her store is 15 minutes from her house and they average 42 scripts per day. Sometimes on Saturday during a 12 hour shift she doesn't even fill 20 scripts. Again an obvious exception that not even 1 out of a 100 should expect to find.
 
I havent heard of one person signing for a 3 year contract much or less being offered one. 99%? Where are you pulling this number from?


No, the simple solution is to jump on board, but not take the sign on bonus. If your that unsure of what your getting yourself into you can avoid the "lock in" by not taking the bonus. Most of my classmates that signed THIS YEAR were offered 1 year contracts, some were offered 2 with larger bonuses. Some took the sign on, some didnt.


Na, thats BS. So 1% of grads who sign with CVS or Walgreens get a decent deal?

You may consider my deal to be good, but it is certainly not unheard of. For now the country is in a shortage, especially in my area of the NE. The ball is in our court. I called alot of the shots in my contract. If your dumb enough to just sign on first sight of the contract you basically screw yourself and get what you deserve. Welcome to the real world. They dont play nice here.

I know of many of my other classmates that signed and have in their contracts "promised stores." Your right that not everyone gets exactly what they want, but if you play the game well MANY can come out with an offer they will be happy with.
 
Finally watched it.

The "blame" isn't on Wags. it's on the system. What do you think happens when the overlords of medicine - the insurance companies - only pay X amount on each prescription? If every pharmacy actually provided enough pharmacists to safely do the job with a decent pace, every single one would go under. Viva, capitalism. It all suits our society perfectly.
 
StallionRx said:
I havent heard of one person signing for a 3 year contract much or less being offered one. 99%? Where are you pulling this number from?


No, the simple solution is to jump on board, but not take the sign on bonus. If your that unsure of what your getting yourself into you can avoid the "lock in" by not taking the bonus. Most of my classmates that signed THIS YEAR were offered 1 year contracts, some were offered 2 with larger bonuses. Some took the sign on, some didnt.


Na, thats BS. So 1% of grads who sign with CVS or Walgreens get a decent deal?

You may consider my deal to be good, but it is certainly not unheard of. For now the country is in a shortage, especially in my area of the NE. The ball is in our court. I called alot of the shots in my contract. If your dumb enough to just sign on first sight of the contract you basically screw yourself and get what you deserve. Welcome to the real world. They dont play nice here.

I know of many of my other classmates that signed and have in their contracts "promised stores." Your right that not everyone gets exactly what they want, but if you play the game well MANY can come out with an offer they will be happy with.
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CVS and Walgreens offers 3 year committments for sign on bonuses to most students...I've been offered this as well
 
WVUPharm2007 said:
Finally watched it.

The "blame" isn't on Wags. it's on the system. What do you think happens when the overlords of medicine - the insurance companies - only pay X amount on each prescription? If every pharmacy actually provided enough pharmacists to safely do the job with a decent pace, every single one would go under. Viva, capitalism. It all suits our society perfectly.
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I disagree. As a fellow Wag's EE you should know that 70% of the drug price goes to the manufacturer, 20% to the retailer, and 10% to the wholesailer. Most drugs that aren't paid by the insurance are not purchased, however, most drugs are controls like lortab and those are some what cheap and the patient still pays for them, so...
 
acetyl said:
I disagree. As a fellow Wag's EE you should know that 70% of the drug price goes to the manufacturer, 20% to the retailer, and 10% to the wholesailer. Most drugs that aren't paid by the insurance are not purchased, however, most drugs are controls like lortab and those are some what cheap and the patient still pays for them, so...
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The pricing is so varied...c'mon, those percentages can't hold up in all cases. Most PBMs reimburse based on what they think is AWP and try to pay as little as possible as a "dispensing fee". Cash paying cutomers are in fact fleeced like crazy...but the third parties get pretty damned good deals.
 
It is fascinating how media fabricate the news...There isn't one field that that operates with 0 errors. I am a food scientist, and the first thing I learned at school, is that in each batch of production, there is a risk of contaminated products that are potentially harmful to the consumer's health. You can not possibely eliminate that risk, all what we are requiered to do is to keep it below certain level. I don't understand what is new in this news...beside that pharmacists haven't been in the spot yet.
I think it is time for people to start sewing the media for ruining reputation and making money of it.
I am with warning the customer about issues, but it should be FAIR and JUST.
I grow up in a place where we highly respect and trust pharmacists more than physicians. It is a shame to see how pharmacists are treated in this country, and they are the ones who go through more rigorous programs and work under much thougher restrictions and regulations.
 
WVUPharm2007 said:
The pricing is so varied...c'mon, those percentages can't hold up in all cases. Most PBMs reimburse based on what they think is AWP and try to pay as little as possible as a "dispensing fee". Cash paying cutomers are in fact fleeced like crazy...but the third parties get pretty damned good deals.
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Those numbers were what was printed in one of their monthly pharmacy magazines, so it's probably pretty close to being accurate from an overall perspective.

I agree that the insurance companies are making money, but mainly only from the amount of money they are receiving in a check each month. C'mon man, how many times have you pushed fill for Lipitor or Advair, where the insurance company is paying more than $100, while the patient is paying about ten bucks for a month supply? I think the news network people were just jealous that they weren't putting up a store every eighteen hours.
 
I wonder how they got those Rx's in the first place. I mean, did they make appointments with doc's and say, I think my blood is clotting too much, can I have some Warfarin? I'm bipolar, can I have something strong?

Or, was it we're 20/20 and doing a story on pharmacies, so we need some fake prescriptions for our reporters. That's really ethical on their part.
 
The "getting the aspirin with the warfarin Rx" angle is really underhanded, too. First and foremost, the majority of the time, there is a tech ringing the patient out, so it is unlikely that they even know of the potential interaction. Then you have the complete bull**** way they do it. They just shove a bottle of aspirin at the cashier and tell them to ring it up. That's bull****. It's the patient's responsibility to ask if any OTC medications are ok with their meds. If I *notice* I'll say something, but to expect me to monitor every little thing the patient buys in the store is ridiculous. I'm just waiting for some asshat "news" guy to come in and get an MAOI, shove some cheese over the counter, then come back 3 months later and ask me why I sold him the potentially lethal Swiss cheese.
 
WVUPharm2007 said:
The "getting the aspirin with the warfarin Rx" angle is really underhanded, too. First and foremost, the majority of the time, there is a tech ringing the patient out, so it is unlikely that they even know of the potential interaction. Then you have the complete bull**** way they do it. They just shove a bottle of aspirin at the cashier and tell them to ring it up. That's bull****. It's the patient's responsibility to ask if any OTC medications are ok with their meds. If I *notice* I'll say something, but to expect me to monitor every little thing the patient buys in the store is ridiculous. I'm just waiting for some asshat "news" guy to come in and get an MAOI, shove some cheese over the counter, then come back 3 months later and ask me why I sold him the potentially lethal Swiss cheese.
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That was my biggest hang-up with the story. Sometimes i even get yelled at when telling people about their otc's
 
WVUPharm2007 said:
The "getting the aspirin with the warfarin Rx" angle is really underhanded, too. First and foremost, the majority of the time, there is a tech ringing the patient out, so it is unlikely that they even know of the potential interaction. Then you have the complete bull**** way they do it. They just shove a bottle of aspirin at the cashier and tell them to ring it up. That's bull****. It's the patient's responsibility to ask if any OTC medications are ok with their meds. If I *notice* I'll say something, but to expect me to monitor every little thing the patient buys in the store is ridiculous. I'm just waiting for some asshat "news" guy to come in and get an MAOI, shove some cheese over the counter, then come back 3 months later and ask me why I sold him the potentially lethal Swiss cheese.
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Soooo....true!

That is why - rxs only at the rx counter. No meat, tomatoe sauce, cheese whatever!!!

I absolutely will and DO counsel on each and every new rx I'm given, but only for the pt. Not for the husband, wife, friend......etc - unless I'm given a release.

The issue here is....and I think they made the point in the broadcast - each rx was new. The techs automatically had the pts sign - indicating they were only acknowledging their receipt of medication - not that they had been or refused counsel.

I actually argue with techs occasionally when I float. I will NOT let a tech hand out a new medication without me there & they CANNOT give out a new medication if I'm not there (at lunch for example). I give the tech one notice - if it happens again, they are not allowed to give any medication out until they can demonstrate compliance . If that is where they are positioned for that day, then they can go home - simple, again.

But - no....I don't ring up foods. I will, however, counsel that MAOI pt on foods and their interactions.
 
sdn1977 said:
I actually argue with techs occasionally when I float. I will NOT let a tech hand out a new medication without me there & they CANNOT give out a new medication if I'm not there (at lunch for example). I give the tech one notice - if it happens again, they are not allowed to give any medication out until they can demonstrate compliance . If that is where they are positioned for that day, then they can go home - simple, again.

But - no....I don't ring up foods. I will, however, counsel that MAOI pt on foods and their interactions.
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How do you guys manage to keep track of all of the patients that come in with a script for a new medication?

Let's say you're in the back filling a control or you're on the phone with a doctor and a patient comes in with a script for a new medication and the tech proceeds to type, count, and fill. After you're done with whatever you were doing, you come to the front to verify and are able to recall that patient "X" is specifically taking x,y,and z medications? Do you check on the computer to see if its a new script?

The three pharmacists whom I work with never counsel unless the patient directly asks to speak with the pharmacist. It's rare that they do otherwise. 😡
 
firstcitizen said:
How do you guys manage to keep track of all of the patients that come in with a script for a new medication?

The three pharmacists whom I work with never counsel unless the patient directly asks to speak with the pharmacist. It's rare that they do otherwise. 😡
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I was trying to visualize this, too...

Our computer system shows <on the verification screen of the pharmacists computer and on the label> which scripts are new v/s those that are refills, transfers, updates for refills, etc. but I guess I'm wondering where one draws the line as far as "new" is concerned. I mean, if you have a script that was transferred in from another pharmacy and pt has filled it there several times before, do you consider it "new" and counsel or trust that adequate counseling was received at the other pharmacy (for that matter, what if it's a refill and the original Rx was filled, verified, and sold while you were not on duty)? I'm just trying to imagine how that would work in my store...

Also, if the patient is not the one picking up, how do you handle counseling and the signature log? I was trained to ask each and every person I rang up if they had questions for the pharmacist before having them sign anything... seven years later and I'm still asking but you wouldn't believe how much heat I take from the pharmacists b/c of it! That (and ringing up groceries) is a story for another time, though 🙄
 
firstcitizen said:
How do you guys manage to keep track of all of the patients that come in with a script for a new medication?

Let's say you're in the back filling a control or you're on the phone with a doctor and a patient comes in with a script for a new medication and the tech proceeds to type, count, and fill. After you're done with whatever you were doing, you come to the front to verify and are able to recall that patient "X" is specifically taking x,y,and z medications? Do you check on the computer to see if its a new script?

The three pharmacists whom I work with never counsel unless the patient directly asks to speak with the pharmacist. It's rare that they do otherwise. 😡
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First, the physical layout of the places I've worked as a retail pharmacist is not so large that it keeps me from knowing what is going on - nothing like working in a hospital pharmacy! Also...I guess I'm just used to "listening" all the time - I'm a parent😳 -- my hearing is impeccable & I've got eyes in the back of my head😉 .

But...practically - there are a number of safeguards in place in every software I've used. First Data Bank is the usual provider of the drug interaction data base, so pharmacists are pretty knowledgable about what it will & won't pick up. Each chain can make its specificity greater or less depending on what they choose.

So...when there is an interaction or a duplicate medication on the profile, it puts in place a "hard halt" or some other phrase which doesn't allow the technician to go on unless overriden by a pharmacist. This is the first place pharmacists get into trouble - they give out their password to the techs so they can override. BIG MISTAKE!!

I get tired, as we all do, of having to overide each time I see a silly interaction. But - thats my job & I won't relinquish it for my ease since there may be one time it really is not a silly interaction. Likewise...when I override it - I can see the dose has changed, or the drug has changed in the same class - lisinopril to quinapril for example. That triggers me to initiate conversation with the pt.

Finally, each rx has a receipt which has a code for a new, refill or reassigned rx. The tech just has to look at that to see what it is - they have no excuse for not knowing.

Finally, in 2006, a law was passed in CA that a new rx must be assigned if anything has changed on any part of the rx itself - even if the sig changed from 1 qd to 1 qd with dinner. So...if I've requested a refill because the refills have run out or the rx is over 1 yr old & the refill ok comes back with a minor sig change - that triggers a new rx...thus a consultation.

I can't speculate why your pharmacists don't counsel, other than just like teaching - some aren't good about it. Even if someone is picking up a refill, I'll chat with them while the tech is ringing the register. We catch up on kids, vacations, the weather - whatever....you'd be surprised what comes up in just regular conversation & how frequently they get back to wanting some information about their drug or condition.
 
Julianne said:
I was trying to visualize this, too...

Our computer system shows <on the verification screen of the pharmacists computer and on the label> which scripts are new v/s those that are refills, transfers, updates for refills, etc. but I guess I'm wondering where one draws the line as far as "new" is concerned. I mean, if you have a script that was transferred in from another pharmacy and pt has filled it there several times before, do you consider it "new" and counsel or trust that adequate counseling was received at the other pharmacy (for that matter, what if it's a refill and the original Rx was filled, verified, and sold while you were not on duty)? I'm just trying to imagine how that would work in my store...

Also, if the patient is not the one picking up, how do you handle counseling and the signature log? I was trained to ask each and every person I rang up if they had questions for the pharmacist before having them sign anything... seven years later and I'm still asking but you wouldn't believe how much heat I take from the pharmacists b/c of it! That (and ringing up groceries) is a story for another time, though 🙄
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Yes - in CA, we consider a transfer a new rx - that is how we make a final check that indeed we get get the tx correct - either on our end or the transferring pharmacy end.

Yes, sometimes I counsel on rxs which I did not do - they were completed on a day I did not work, but it was picked up on my day. I go over the drug, directions, what is used for etc.....If there are any concerns about it being correct as to what the prescriber wrote - I look it up myself. Otherwise, I trust my colleagues they did indeed fill it correctly, just as they do me. Rarely is this an issue at all.

In CA, counseling can only be done with the pt or the pts authorized representative, if adults. Every child's rx has to have the child's parent or guardian counseld, if present. So, if a friend picks up the rx, I cannot nor do not counsel, but I do say be sure to have the pt call me if he/she has any questions.

So, when they are signing the sig log - they are only signing the portion they are picking up the rx - the acknowledgement of counseling is not checked - it is left blank intentionally. The sig log has 2 functions - one is for insurance acknowledgement - the other is for counsel acknowledgment. Do not check the box if the pharmacist did not counsel.

This is for CA law only - I don't know what its like in other states.
 
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