MrBonita

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Mar 13, 2016
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Hello Pharmacy Friends. It looks like Amazon is going into the PBM business. They will have the drivers and space to take over suppliers like Bergen and Cardinal. I believe they can provide lower prices and better service to local independent pharmacies. I think their main goal is to supply pharmacies with drugs and then offer a mail order service using local pharmacies and charging them a fee of 8 percent like they do for Amazon sellers. What do you guys think? Since they will be the PBM then they can reimburse the pharmacy for filling the drugs and then having the local pharmacy mail out the drugs on their behalf. I can see Amazon sending their own top 400 drugs to the consumer themselves and it will be a great benefit to their scheme.

Amazon is taking on the drug supply chain, says report
 

lord999

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Hello Pharmacy Friends. It looks like Amazon is going into the PBM business. They will have the drivers and space to take over suppliers like Bergen and Cardinal. I believe they can provide lower prices and better service to local independent pharmacies. I think their main goal is to supply pharmacies with drugs and then offer a mail order service using local pharmacies and charging them a fee of 8 percent like they do for Amazon sellers. What do you guys think? Since they will be the PBM then they can reimburse the pharmacy for filling the drugs and then having the local pharmacy mail out the drugs on their behalf. I can see Amazon sending their own top 400 drugs to the consumer themselves and it will be a great benefit to their scheme.

Amazon is taking on the drug supply chain, says report
Working on a 1492 contract right now, it's not going to be that far yet. I can't talk about what 1492 is cooking up besides that pharmacy is not the only targeted market, but it's actually quite a bit more ambitious than that based on some of the other divisions at South Lake Union (UW HSRV PhDs are basically being recruited wholesale right now).
 
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WVUPharm2007

imagine sisyphus happy
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So where do I send my application? I'm ready to assimilate with the borg.
 
Sep 25, 2017
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Based on all the news surrounding Amazon lately, it seems apparent that the company is seriously considering entry into the Pharmacy business. Whether Amazon will go or not go into the pharmacy business I think is not a matter of 'if' as it is more a matter of 'when'. The company has repeatedly looked for large industries to disrupt and in my opinion the pharmaceutical industry fits the mold perfectly.

So my question goes out to all the existing pharmacists - Where do you see the role of pharmacists if Amazon were to invade the pharmacy industry?

Since I'm not a pharmacist myself, I can't answer that question as I don't know ALL the duties and responsibilities a pharmacist performs. (Someone please tell me what verifying Rxs means?) But I would assume everything that a pharmacist does can be automated (no disrespect) leaving a vast majority of existing pharmacists in retail unemployed?

The way I look at it is this: AmazonRx enters the world. CVS and Walgreens try to hold on but eventually go under as they don't have the delivery infrastructure in place to provide delivery in 24-48hours. AmazonRx crushes CVS and Walgreens as its main competitors, forcing their pharmacy to close. Retail pharmacists working there become unemployed.

Sure AmazonRx will need some pharmacists but no where near the numbers employed by the CVS/Wags today. AmazonRx will probably role out automation (robots) to their fulfillment centers and employ only a handful to abide by Rx laws that a pharmacists must be onsite to dispense (Don't know the law exactly correct me if I'm wrong). Then they'll probably hire another handful to provide mobile Rx counseling.

So the way I see this pharmacist field is once Amazon makes its entry into the Pharmacy business, there goes the profession into the grave, as automation will be the norm. Its a sad doom and gloom assessment but someone please correct me if I'm wrong.

I've been accepted into a pharmacy school and have been deliberating heavily on whether I should go or not. I like the science behind it and respect the profession hence why I applied in the first place. However, it just seems so so SO RISKY to go in debt 200K+ come out to an established saturated market with an impending entry from Amazon to be the final straw that broke the camels back taking the profession and the majority of retail positions into the grave.
 
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PharmDude120k

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Oct 3, 2017
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Regardless Amazon won't revolutionize the pharmacy world overnight. I think there's a problem within our profession of us assuming Armageddon will always happen on a certain date. You will generally have the opportunity to adapt. Even taxi drivers had to option of working at Uber once their careers disappeared overnight. And isn't Walmart still going strong even though Amazon has been selling merchandise to people's doorsteps for cheaper for the past 20 years? I also believe that if someone sets themselves apart from their peers they will be better able to weather the storm. I think the fundamental point that people forget about when talking about over-graduation of pharmacists is that they assume all the graduates are the same quality as before. The fact of the matter is that when pharmacy schools open up and increase their enrollment they have to pick from the bottom of the barrel to do so. If you're above the average person in your class in terms of work experience, knowledge and ability to do your job then I'd stop worrying and simply plan you're next move. In the same way, if you develop desirable skillsets you will always have the option to jump ship (e.g. work at Amazon). The trick is to continually adapt as more information becomes available. Pharmacy isn't the only profession that is feeling the squeeze.

You also can't ignore that mail order has limitations. How big do mail order sales get before medication degradation during shipment becomes the next national issue? Amazon will basically have to buy the pharmaceutical wholesale business to get the type of distribution necessary to safely ship medications and somehow figure out how to safely get medications to the customer through the mail (at least in the future when people start to realize they're having heart attacks because their lisinopril doesn't do so well in a 120 degree mailbox). Wait, isn't this why local retail pharmacies exist in the first place?

Amazon doesn't need local retail pharmacies to mail prescriptions for them. Pharmacies get inventory within one business day from wholesalers due to the extensive drug distribution networks. Once Amazon buys Cardinal, McKesson and AmerisourceBergen and makes some adjustments they'll be able to ship meds to everyone's doorstep next day. The value local retail pharmacies serve is to store the medications safely in necessary quantities and offer in person consultation with a pharmacist. Let just hope society sees and understands the benefits that local pharmacy retailers provide.

It's interesting to me that mail order prescription volumes have gone down while sales have increased (I haven't been on SDN long enough yet to post links but Google this article title: "IMS 2015 Use of Medicines Report: US Sales Reach $424.8 Billion"). You would think the easy, cheap medications should be sent through the mail and the specialty drugs should require the most monitoring by local pharmacists. But hey, it's all about the profit margin right?

Bottom line: It feels like every issue in pharmacy right now is based on the fact that everyone wants to undermine pharmacists and bypass the value they add to society. It's our job to push for a substantial role in whatever the future medication delivery system may be.
 
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tlh908

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My question is when will the taxpayers stop subsidizing Amazon. They have had plenty of tax breaks and then they get the post office to deliver below cost. It is time to stop the cronyism and make Amazon pay the post office actual cost.
 

Pharmd = Phake Doctor

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A whole bunch of meaningless platitudes that have no basis in reality.

Bottom line: It feels like every issue in pharmacy right now is based on the fact that everyone wants to undermine pharmacists and bypass the value they add to society. It's our job to push for a substantial role in whatever the future medication delivery system may be.
Sorry, but your last post is a bunch of hot air. I've never seen a higher concentration of wishful thinking than your last post.

No one, and I mean no one, pays pharmacists a 120K salary for "the value they add to society" outside of dispensing as much drugs as they can to the customers. If you can't do that, then corporate will find someone who will do it for less money.

FYI: Our six-figure salary is a relic or the early 2000s when corporate pharmacy was expanding and the demand for licensed pharmacists exceeded the supply. Back then, pharmacists could actually bargain for better pay and better working conditions. Now that supply is exceeding demand, pay has stagnated and the working conditions have deteriorated. It's gonna get worse, and our powerless pharmacy organizations have no real solutions to the problems this profession faces.

Also, retail pharmacy (and even hospital pharmacy) doesn't care if you were a straight-A student or barely passed school when it comes to doing your job (CVS, Wags, HCA, CHA don't give a sh#$ about that). Do you actually believe that grades will somehow differentiate you from your peers? I've seen stellar students rot away in a BFE hospital or retail pharmacy because they didn't have the right connections (hint: nepotism). I've seen residency-trained pharmacists get passed up for jobs and promotions because the hospitals knew they could get someone cheaper.

Based on this post and the posts you made about getting an MBA, I'm thinking you have very little exposure to the real world. I'm surprised. You claim to have worked at an independent pharmacy, but you have an overly unrealistic view of the problems facing this profession.
 
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gwarm01

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Oct 7, 2009
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(Someone please tell me what verifying Rxs means?) But I would assume everything that a pharmacist does can be automated (no disrespect) leaving a vast majority of existing pharmacists in retail unemployed?
The funny thing is that the one duty that isn't easily automated is the one you aren't aware of.

You're working at an inpatient pharmacy and a patient gets admitted to the ICU from the ED and the medication orders come into your verification queue. You look over their chart, see the diagnosis, check labs and notes, and evaluate the orders to see if they are appropriate for this patient and their condition. It takes human judgement since computers aren't currently smart enough to disregard insignificant drug interactions, understand when a potential risk is outweighed by the benefits, or to realize when something might be used off label. There are things that require a conversation with the prescriber to change, verify intent, or just to discuss treatment.

Computers are by the book. Check a database, yes or no. Medicine is full of grey areas. Those reference books weren't handed down by god, it came from human beings trying new things and developing better treatments. You need a human being to make decisions on matters like these until true AI comes around. This is an aspect of our job that is poorly understand by the public, but may just be the one thing that keeps you employed in the future. Robots can pour pills into a bottle, but it takes a human to decide if that pill was the one that should have been poured in the first place.
 
Sep 25, 2017
32
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Pre-Pharmacy
The funny thing is that the one duty that isn't easily automated is the one you aren't aware of.

You're working at an inpatient pharmacy and a patient gets admitted to the ICU from the ED and the medication orders come into your verification queue. You look over their chart, see the diagnosis, check labs and notes, and evaluate the orders to see if they are appropriate for this patient and their condition. It takes human judgement since computers aren't currently smart enough to disregard insignificant drug interactions, understand when a potential risk is outweighed by the benefits, or to realize when something might be used off label. There are things that require a conversation with the prescriber to change, verify intent, or just to discuss treatment.

Computers are by the book. Check a database, yes or no. Medicine is full of grey areas. Those reference books weren't handed down by god, it came from human beings trying new things and developing better treatments. You need a human being to make decisions on matters like these until true AI comes around. This is an aspect of our job that is poorly understand by the public, but may just be the one thing that keeps you employed in the future. Robots can pour pills into a bottle, but it takes a human to decide if that pill was the one that should have been poured in the first place.

Thank you very much for explaining that to me. So verifying Rxs occurs primarily in a hospital setting and not in a retail setting as a patients charts/lab are not made available to view for pharmacist.

Back to the Amazon discussion: Is there any duty/task performed by a retail pharmacist that cannot be imminently automated by Amazon? (Again just to iterate I mean no disrespect, I only ask this to assess job security for retail pharmacists, without taking into consideration the retail saturation problem. Amazons entry would evidently accelerate automation to ensure the profit margins their head honchos are looking for....right?
 

genesis09

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Feb 27, 2006
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The majority of pharmacist tasks cannot be automated. It is pharmacy tech tasks which can be automated. You cannot automate DUR, fill and label accuracy, and counseling. We all have seen the automated drug interaction systems. Most of the interactions are not important.

Pharmacy is not like normal retail. It is highly regulated. They can't just bully the boards. All they could be is another mail order pharmacy. Mail order is the only sector which has seen a decrease in Rx filled. The big money is PBM. Becoming a wholesaler is more likely than regular pharmacy.
 

Corpseman

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Nov 7, 2010
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Pharmacist
Based on all the news surrounding Amazon lately, it seems apparent that the company is seriously considering entry into the Pharmacy business. Whether Amazon will go or not go into the pharmacy business I think is not a matter of 'if' as it is more a matter of 'when'. The company has repeatedly looked for large industries to disrupt and in my opinion the pharmaceutical industry fits the mold perfectly.

So my question goes out to all the existing pharmacists - Where do you see the role of pharmacists if Amazon were to invade the pharmacy industry?

Since I'm not a pharmacist myself, I can't answer that question as I don't know ALL the duties and responsibilities a pharmacist performs. (Someone please tell me what verifying Rxs means?) But I would assume everything that a pharmacist does can be automated (no disrespect) leaving a vast majority of existing pharmacists in retail unemployed?

The way I look at it is this: AmazonRx enters the world. CVS and Walgreens try to hold on but eventually go under as they don't have the delivery infrastructure in place to provide delivery in 24-48hours. AmazonRx crushes CVS and Walgreens as its main competitors, forcing their pharmacy to close. Retail pharmacists working there become unemployed.

Sure AmazonRx will need some pharmacists but no where near the numbers employed by the CVS/Wags today. AmazonRx will probably role out automation (robots) to their fulfillment centers and employ only a handful to abide by Rx laws that a pharmacists must be onsite to dispense (Don't know the law exactly correct me if I'm wrong). Then they'll probably hire another handful to provide mobile Rx counseling.

So the way I see this pharmacist field is once Amazon makes its entry into the Pharmacy business, there goes the profession into the grave, as automation will be the norm. Its a sad doom and gloom assessment but someone please correct me if I'm wrong.

I've been accepted into a pharmacy school and have been deliberating heavily on whether I should go or not. I like the science behind it and respect the profession hence why I applied in the first place. However, it just seems so so SO RISKY to go in debt 200K+ come out to an established saturated market with an impending entry from Amazon to be the final straw that broke the camels back taking the profession and the majority of retail positions into the grave.

why did you go into pharmacy school knowing so little? Did your school not require any shadowing or experience?

CVS and Wags don't really need the infrastructure to deliver a medicine within 48 hours as they can get it out in 15-20 mins to a pt in the drive thru on the way home from work. Also, don't forget a lot of patients hate mail order and want to come to the pharmacy just to bother us.
 
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PharmDude120k

2+ Year Member
Oct 3, 2017
30
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Sorry, but your last post is a bunch of hot air. I've never seen a higher concentration of wishful thinking than your last post.

No one, and I mean no one, pays pharmacists a 120K salary for "the value they add to society" outside of dispensing as much drugs as they can to the customers. If you can't do that, then corporate will find someone who will do it for less money.

FYI: Our six-figure salary is a relic or the early 2000s when corporate pharmacy was expanding and the demand for licensed pharmacists exceeded the supply. Back then, pharmacists could actually bargain for better pay and better working conditions. Now that supply is exceeding demand, pay has stagnated and the working conditions have deteriorated. It's gonna get worse, and our powerless pharmacy organizations have no real solutions to the problems this profession faces.

Also, retail pharmacy (and even hospital pharmacy) doesn't care if you were a straight-A student or barely passed school when it comes to doing your job (CVS, Wags, HCA, CHA don't give a sh#$ about that). Do you actually believe that grades will somehow differentiate you from your peers? I've seen stellar students rot away in a BFE hospital or retail pharmacy because they didn't have the right connections (hint: nepotism). I've seen residency-trained pharmacists get passed up for jobs and promotions because the hospitals knew they could get someone cheaper.

Based on this post and the posts you made about getting an MBA, I'm thinking you have very little exposure to the real world. I'm surprised. You claim to have worked at an independent pharmacy, but you have an overly unrealistic view of the problems facing this profession.
I'll limit my response to one post so that others may continue discussing Amazon.

First of all, nice to meet you. Based on your post I'm guessing you're not a very optimistic person overall. But hey, who am I to judge a person based on a few online forum posts right? Do you know what all the independent pharmacy owners who are still making bank in this market have in common? They see opportunity and pursue it relentlessly while others drown in their own tears complaining how everyone is going to be fired on November 14, 2021. Guess what, negative people stay in positions that breed negative ideas. Do you have any idea how many other occupations there are within pharmacy other than retail or how retail will evolve or how many fields will open up in the future as pharmacist time is freed up for for other tasks? I guess we'll find out together. What I can say is that if pharmacists continue to have such a negative opinion of the profession no one is going to value or ask for your service in the future regardless of how beneficial we can be. Deteriorating working conditions? I just got a ride from a tow truck driver that makes 30k a year to work 60+ hour weeks being on call 24/7 driving people home from horrific accidents. People starve to death in this world everyday and you're here complaining about having to answer a phone, give standard customer service, meet metrics like any other job (guess what pharmacy isn't the only industry with bureaucracy) and get paid 120k a year to live in one of the world's wealthiest countries? Give me a break. You know what actually happened to this profession? This field attracted a bunch of lazy whiners "back when pharmacist salaries were justified" and now we have to deal with them complaining about having to work and their inability to innovate.

I never even mentioned pharmacist salary in my post. The problem with the current model is that pharmacies get paid for dispensing prescriptions rather than the services they perform. Chains have no choice but to be merciful and keep us on filling endless scripts to make the financials work out because we've created no incentive otherwise. If I have to explain to you that pharmacists are capable of adding value to the system then feel free to do everyone a favor and quit your job and go become the criminal defense lawyer you know you want to be. There's a reason laws exist requiring a pharmacist to verify scripts. There's a reason physicians have to write a prescription before a patient can get an Rx med. Just because pharmacists aren't utilized as effectively as they could in the current system doesn't mean they're not worth 120k. Guess what, the field IS changing. Actually, the world is changing. And no one is going to hand you a cushy job if you don't convince the public and legislators that pharmacist intervention=improved outcomes and that a pharmacists time is better spent monitoring drug therapy rather than counting by fives (which can and should be automated). I'm aware pharmacist supply is increasing. It doesn't mean jobs will go to zero. What it does mean is that you will have to provide services no machine can and do it better than all your peers who only went through the program because universities were willing to take their money. Why don't you try advocating for the profession or position yourself for future jobs rather than spending all your energy telling the world how doomed we are? I sure hope you don't talk about the profession the same way with your customers and the general public.

Did you really just start attacking my grades when you know absolutely nothing about my grades or my perspective? In none of my posts on this entire website have I mentioned grades. I've always been one of the people that learns the important information first, skips the garbage (e.g. I don't need to memorize the structure of albuterol), and then gets the grades that result rather then spending my time trying to get an A on some arbitrary test. Work experience is king.

I'm graduating from school essentially debt free (thank you irrelevant grades that got me all those scholarships) with sound business knowledge and an extra degree to market to a wide variety of industries. Guess what, a machine can't manage employees or market and implement immunization clinics. When I step in on day one and increase cash flows by increasing stock returns thus increasing inventory turnover guess who will become indispensable--me (a common issue in independent stores at least). And the higher you go up the more valuable that knowledge becomes. That's what I get for trying to share my experiences online to help people make their own decisions. I should know better than to feed the trolls actually.
 
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wagrxm2000

A different perspective
5+ Year Member
Sep 17, 2014
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The funny thing is that the one duty that isn't easily automated is the one you aren't aware of.

You're working at an inpatient pharmacy and a patient gets admitted to the ICU from the ED and the medication orders come into your verification queue. You look over their chart, see the diagnosis, check labs and notes, and evaluate the orders to see if they are appropriate for this patient and their condition. It takes human judgement since computers aren't currently smart enough to disregard insignificant drug interactions, understand when a potential risk is outweighed by the benefits, or to realize when something might be used off label. There are things that require a conversation with the prescriber to change, verify intent, or just to discuss treatment.

Computers are by the book. Check a database, yes or no. Medicine is full of grey areas. Those reference books weren't handed down by god, it came from human beings trying new things and developing better treatments. You need a human being to make decisions on matters like these until true AI comes around. This is an aspect of our job that is poorly understand by the public, but may just be the one thing that keeps you employed in the future. Robots can pour pills into a bottle, but it takes a human to decide if that pill was the one that should have been poured in the first place.
I feel like this is PaToPharm and he actually did create a new account.

If not, I'll never understand why someone wants to troll the pharmacy forum.
 

DrVader

2+ Year Member
Feb 5, 2017
309
374
Hello Pharmacy Friends. It looks like Amazon is going into the PBM business. They will have the drivers and space to take over suppliers like Bergen and Cardinal. I believe they can provide lower prices and better service to local independent pharmacies. I think their main goal is to supply pharmacies with drugs and then offer a mail order service using local pharmacies and charging them a fee of 8 percent like they do for Amazon sellers. What do you guys think? Since they will be the PBM then they can reimburse the pharmacy for filling the drugs and then having the local pharmacy mail out the drugs on their behalf. I can see Amazon sending their own top 400 drugs to the consumer themselves and it will be a great benefit to their scheme.

Amazon is taking on the drug supply chain, says report
I work for the red devil and idiots run the company. A smart company is going to going to crush CVS and Walgreens. Too long both companies have been complacent. They haven't try to improve their business model. Amazon will crush them all.
 
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WVUPharm2007

imagine sisyphus happy
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I work for the red devil and idiots run the company. A smart company is going to going to crush CVS and Walgreens. Too long both companies have been complacent. They haven't try to improve their business model. Amazon will crush them all.
Yup.

Pitt grad Yinzer Larry and his merry band of Rhode Island misfits vs Princeton grad Jeff and his Silicon Valley Borg?

Lolz.

Like I said, just tell me where to send the application. We already know who's gonna win this one.
 

Pharmd = Phake Doctor

Phorum Hedonist
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Apr 24, 2016
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Triggered Snowflake Rambling
I'm laughing my a#$ off reading your post. I guess being critical these days is viewed as 'being negative'. It's obvious I triggered you. Do you need to go to your safe space?

Did you really just start attacking my grades when you know absolutely nothing about my grades or my perspective? In none of my posts on this entire website have I mentioned grades.
Can you comprehend English? When did I attack you for your grades? In my previous post, I said that CVS/WBA/HCA/CHA doesn't care about your GPA when they hire pharmacists. Is that so hard to comprehend?

I couldn't care less about your 3.8 GPA. You think that makes you special? I have a 3.8 GPA, and I know a bunch of people with GPAs in that range. You are nothing special. I even have scholarships because of my grades. So what? Do you think corporate pharmacy cares about that?

Do you know what all the independent pharmacy owners who are still making bank in this market have in common? They see opportunity and pursue it relentlessly while others drown in their own tears complaining how everyone is going to be fired on November 14, 2021.
I'm amazed. "They see opportunity and pursue it relentlessly" has to be the most generic answer anyone could give. Did you actually work at an independent pharmacy? This has to be the least descriptive thing I have ever read. My uncle owns a successful independent pharmacy. He taught me alot about what has allowed him to be successful. And he's taught me about the difficult decisions and hardships he had to overcome. Having to collect delinquent balances on charge accounts, figuring out how to prevent distributors from ripping him off, and (now) trying to fight DIR fees... to name a few things he's had to face. Its good to know that all this hardship can be reduced by some amateur who thinks he's God's gift to pharmacy as "they see opportunity and pursue it relentlessly".

I just got a ride from a tow truck driver that makes 30k a year to work 60+ hour weeks being on call 24/7 driving people home from horrific accidents. People starve to death in this world everyday and you're here complaining about having to answer a phone, give standard customer service, meet metrics like any other job (guess what pharmacy isn't the only industry with bureaucracy) and get paid 120k a year to live in one of the world's wealthiest countries?
Are you trying to hint that you've never worked in a pharmacy? If you did, then you wouldn't describe it as "answer a phone, give standard customer service, meet metrics like any other job". Have you ever stepped into a pharmacy in your life?

The problem with the current model is that pharmacies get paid for dispensing prescriptions rather than the services they perform. Chains have no choice but to be merciful and keep us on filling endless scripts to make the financials work out because we've created no incentive otherwise.
Pass me the kool-aid comrade. If the chains could find a way to get rid of us, they would have done so a long time ago. They couldn't give a s#$% about you or me.

I'm graduating from school with sound business knowledge and an extra degree to market to a wide variety of industries:bullcrap:. Guess what, a machine can't manage employees or market and implement immunization clinics.:banana: When I step in on day one and increase cash flows by increasing stock returns thus increasing inventory turnover guess who will become indispensable:lol:--me (a common issue in independent stores at least). And the higher you go up the more valuable that knowledge becomes. That's what I get for trying to share my experiences online to help people make their own decisions. I should know better than to feed the trolls actually.
I laugh every time I read this paragraph. I know you're trying real hard to sound like you're an undiscovered talent who's gonna change the pharmacy world, but you end up coming off as an immature college student who has never held a real job.:rofl:
 

GrapePropel

pharmaCYST
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Sep 26, 2017
124
22
PharmaSissy, Cucked, NV
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Another indication why it's all going south...
Get that OT while you can! There wont be much money left in a few years. The pharmacy plane is crashing. And there are no survivors baby!
 

GrapePropel

pharmaCYST
Removed
Sep 26, 2017
124
22
PharmaSissy, Cucked, NV
Status
Pharmacy Student
Yup.

Pitt grad Yinzer Larry and his merry band of Rhode Island misfits vs Princeton grad Jeff and his Silicon Valley Borg?

Lolz.

Like I said, just tell me where to send the application. We already know who's gonna win this one.
If there is a silver lining to all this at least I will live to see the Red Devil die a slow and painful death. RIP my three letter friend. >:)
 
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