Arbitrary list of 35 things that annoy me

[WVUPharm2007]

---

Members do not see this ad.

1) Nurses that lie about what time they hung a vanc/gent/whathaveyou.

2) Student Loans

3) Those stupid little watermarks TV channels put at the bottom of the screen

4) People that use Mac computers and claim that Windows is too hard to use. Of course, these people neglect to inform you that they are complete idiots that don't know how to use a damned computer.

5) The kids these days that call themselves a "PharmD Candidate" their 1st year of school. 🙄

6) Any pharmacy school opened during the 21st century. If you graduated from St. Bubba's Episcopalian School of Pharmacy or whatever the hell it is, I fear you ever doing anything other than retail/mail order. 100 beautiful years of it not really mattering what school you graduated from and now this crap
happens.

7) The medication Bermuda Triangle that makes 1/3 off all medications that leave my pharmacy fall off of the face of the Earth...prompting some random nurse to scream at me because some guy's Allbee with C isn't there...and he NEEDS IT RIGHT NOW.

8) The police. The ones with badges AND Sting's band.

9) Having to get my car inspected

10) The BCS system

11) Barrack Obama

12) John McCain

13) Japanese Cars

14) Korean Cars

15) German Cars

16) Itali...well...hell...Any car that isn't American.

17) GM cars. Because they arbitrarily explode.

18) People that PM me asking for advice about school. Why the hell do people ask ME for advice?!?! It took me 5 years to graduate.

19) The city of Pittsburgh. God damn Yinzers.

20) When there a two lane road that merges into one lane 1/4 mile down the road, you're in line on the right side like everyone else, and then some ******* comes blazing down the left side and tries to butt into traffic. I don't let them in. I've rammed people before just to prove a point. What the hell do I care, I drive a beaten up, rusted, decade-old Taurus...and it's legally their fault anyway.
What would happen if you were in line at McDonalds and some guy stepped to the left of the line and worked his way into the front of the line? Chaos, that's what.

21) The fact that people who work at Sheetz get paid more than a few of my pharmacy technicians.

22) The ******ed names people give kids these days. This is my child, Quinzkie Xavier.

23) Hyphenated names. Or, worse, multiple-hypen names from the children of *******s who hyphenated their children's names. Hi, I'm John Smith-Field-Rose-McBride. Pretty soon it will be like those guys you know that are second generation Indians whose "full" names are like 23 pages long in 10 point font.

24) The smell outside after the honeydipper comes by to drain the neighbor's tank.

25) Hipsters...and their stupid thick, black framed glasses.

26) Microwaved food.

27) Ballpark brand hotdogs. Hebrew Nat'l is only a few bucks more you no-taste-bud-having sapps.

28) People with handicapped parking permits that walk better than I do.

29) People that drive Jettas or Scions.

30) People that played in the band in high school 8 years ago that still whine to this day about how popular the football players were.

31) The societal expectation of having to leave tips for waiters/waitresses.

32) Xopenex.

33) Physicians who refuse to let me switch someone to albuterol from Xopenex.

34) Nurses that tell me I don't look old enough to be a pharmacist, then proceed to call me "hon."

35) Neckties.

Yes...
...
...
...indeedy.

 

[medicalCPA]

Hon, you have a case of the Mondays.

*In best baby voice* Coochie, coochie, coo!

 

[JerryPharmD]

Shouldn't East Carolina be on there somewhere?

(I'm only giving you a hard time. My Wolverines have sucked hard since the season opener last year. I still get s--- for it at work).

 

[RogerWilco]

Excellent thread

 

[tussionex]

excellent list. complete agreement with #1 and #7.

but, what's a honeydipper?


oh, and i DETEST ( with the white hot passion of a supernova ) hyphenated names. if you like your name, don't change it. if you want your spouse's change it. none of this *****wise have-your-cake-and-eat-it-too nonsense.

 

[Glycerin]

32) Xopenex.

33) Physicians who refuse to let me switch someone to albuterol from Xopenex.

One of my projects recently has been to make a formulary change from Xopenex to albuterol...

...and it worked. 👍

 

[npage148]

What did the BCS system ever do to you?

 

[KUMoose]

What did the BCS system ever do to you?

The BCS is so worthless that the very presence offends every right thinking person. The creators should be taken out back and stabbed, shot, burned, disemboweled, hung, drawn and quatered, impaled (welcome back Vlad) and beheaded. Their still living body parts should then be scattered to the four winds in glyph encased trunks as a future warning to all people who believe subjective opinions are better at determining a national champion then head to head play.

 

[confettiflyer]

What did the BCS system ever do to you?

It robs us of an exciting bracket based playoff =( I don't think we enjoy the Associated Press determining who the champion is.

 

[npage148]

OH that BCS system, not the Biopharmaceutical Classification system (BCS system).

http://www.fda.gov/CDER/GUIDANCE/3618fnl.htm

 

[Majic]

OH that BCS system, not the Biopharmaceutical Classification system (BCS system).

http://www.fda.gov/CDER/GUIDANCE/3618fnl.htm

That was awesome...

 

[WVUPharm2007]

but, what's a honeydipper?

Possibly the worst job on the planet.

 

[Pharmavixen]

4) People that use Mac computers and claim that Windows is too hard to use. Of course, these people neglect to inform you that they are complete idiots that don't know how to use a damned computer.

Tell them Windows ripped off Mac.

Though what tees me off (even though I'm a Mac user), are the people who use up my all-too-little off time. I'm out with my friends at the end of the work week, and everybody gets into an argument over what's better, Mac or PC. It's, like, even more boring than hockey.

And don't get me started on Linux snobs.

 

[WVUPharm2007]

Tell them Windows ripped off Mac.

Though what tees me off (even though I'm a Mac user), are the people who use up my all-too-little off time. I'm out with my friends at the end of the work week, and everybody gets into an argument over what's better, Mac or PC. It's, like, even more boring than hockey.

And don't get me started on Linux snobs.

I know a bunch of idiot hipsters I can't stand but have to hang out with occasionally for reasons I won't get into. They actually had a party when an Apple Store opened near them. What a bunch of weirdos. Unless you are stupid, you should be able to use a Mac, PC, or Ubuntu Linux with ease. Which makes spending $500 more on a Mac seem crazy...

 

[PharmDstudent]

WVU's rant thread... hmmmm...

I saw a honeydipper truck not too long ago. The name freaked me out! To think that a company would associate honey with raw sewage...

A hyphenated last name is irritating for that person and the people who have to process data with that name. Women with hyphenated last names never know what name their accounts are under... is it Smith, Jones, or Smith-Jones? I can't run insurance cards with a hyphen for the most part, so the person either gets the first, the second, or both of the names smushed together. 🙄

 

[Pharmavixen]

I know a bunch of idiot hipsters I can't stand but have to hang out with occasionally for reasons I won't get into. They actually had a party when an Apple Store opened near them. What a bunch of weirdos. Unless you are stupid, you should be able to use a Mac, PC, or Ubuntu Linux with ease. Which makes spending $500 more on a Mac seem crazy...

Well...Macs still are largely a virus-free zone.

My friends are geeks rather than hipsters, though there's one guy who got himself an iPhone, and uses every excuse to take it out. Sort of like the Blackberry people six years ago.

34) Nurses that tell me I don't look old enough to be a pharmacist, then proceed to call me "hon."

I'm tiny so I had that problem for years. Though when you're 40, you might wish it still happened...And I've been called worse things by the nurses I work with.

 

[rxlynn]

1
23) Hyphenated names. Or, worse, multiple-hypen names from the children of *******s who hyphenated their children's names. Hi, I'm John Smith-Field-Rose-McBride. Pretty soon it will be like those guys you know that are second generation Indians whose "full" names are like 23 pages long in 10 point font.


.

OK - I'm glad I'm not the only one who hates this. And, really - what are these kids going to do when they grow up and little Jose Martinez-Gonzalez falls in love with Ashley Smith-Green??? But, the kids presumably had no choice in the matter, at least initially. What drives me to distraction (as another poster also mentioned) is women who come to the pharmacy and seem to have no idea which last name they are using this week. I guess it does sort of explain why they can't take medicine correctly though - if you can't even keep your name straight, then medication is probably several levels above the available intellect.

 

[SexyPlexi]

OK - I'm glad I'm not the only one who hates this. And, really - what are these kids going to do when they grow up and little Jose Martinez-Gonzalez falls in love with Ashley Smith-Green??? But, the kids presumably had no choice in the matter, at least initially. What drives me to distraction (as another poster also mentioned) is women who come to the pharmacy and seem to have no idea which last name they are using this week. I guess it does sort of explain why they can't take medicine correctly though - if you can't even keep your name straight, then medication is probably several levels above the available intellect.

***writes in planner: "Change name officially through insurance so I remember which last name to use at the pharmacy and don't look like an idiot."

 

[BADD281]

1) Nurses that lie about what time they hung a vanc/gent/whathaveyou.

2) Student Loans

3) Those stupid little watermarks TV channels put at the bottom of the screen

4) People that use Mac computers and claim that Windows is too hard to use. Of course, these people neglect to inform you that they are complete idiots that don't know how to use a damned computer.

5) The kids these days that call themselves a "PharmD Candidate" their 1st year of school. 🙄

6) Any pharmacy school opened during the 21st century. If you graduated from St. Bubba's Episcopalian School of Pharmacy or whatever the hell it is, I fear you ever doing anything other than retail/mail order. 100 beautiful years of it not really mattering what school you graduated from and now this crap
happens.

Hmmm... I don't like meet someone and say "Hey, I'm Dustin PharmD Candidate c/o 2012" but I mean it IS on my school-issued name tag and I do use it on my emails. Whats wrong with that? Didn't your school call you a PharmD candidate? I consider it a great accomplishment to be here and hell yeah I'm going to acknowledge it when given the opportunity. 🙄

 

[Glycerin]

Hmmm... I don't like meet someone and say "Hey, I'm Dustin PharmD Candidate c/o 2012" but I mean it IS on my school-issued name tag and I do use it on my emails. Whats wrong with that? Didn't your school call you a PharmD candidate? I consider it a great accomplishment to be here and hell yeah I'm going to acknowledge it when given the opportunity. 🙄

It's typically and traditionally only used for 4th year (or 6th year in 0-6 schools or 3rd year in 3-year schools) pharmacy students on rotations, since they are almost finished and are a candidate for the degree.

I agree with WVU. I didn't start using that title until this past spring.

 

[WVUPharm2007]

It's typically and traditionally only used for 4th year (or 6th year in 0-6 schools or 3rd year in 3-year schools) pharmacy students on rotations, since they are almost finished and are a candidate for the degree.

I agree with WVU. I didn't start using that title until this past spring.

Bingo...

 

[MountainPharmD]

1)Nurses that lie about what time they hung a vanc/gent/whathaveyou.

7) The medication Bermuda Triangle that makes 1/3 off all medications that leave my pharmacy fall off of the face of the Earth...prompting some random nurse to scream at me because some guy's Allbee with C isn't there...and he NEEDS IT RIGHT NOW.

33) Physicians who refuse to let me switch someone to albuterol from Xopenex.

34) Nurses that tell me I don't look old enough to be a pharmacist, then proceed to call me "hon."

Sounds like your typical hospital pharmacist experience. I take retail any day of the week over all that. I found when I worked at a hospital the least respected person was the pharmacist. The nurses are always bitching at you because they can never find anything. The doctors are annoyed by you most of the time and consider you a nuisence. You certainly never counsel patients which might actually do some good.

 

[WVUPharm2007]

Sounds like your typical hospital pharmacist experience. I take retail any day of the week over all that.

HAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA
*gasp*
HAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA..oh....hahaha...ha....

No, just, no. Retail is the cesspool of pharmacy practice. Nurses I can deal with. Dealing with the general public is a fate I wouldn't wish upon any human being. Really, you are dealing with wannabe know-it-alls either way. At least a nurse is a more apt fake know-it-all. So a nurse lied about when they hung a dose. You can figure that out on your own. At least I don't have to deal with an oxy addict that "lost" their oxycodone and will probably come back 4 hours later and perform an armed robbery on me. If someone orders a drug, I send it to them. You don't deal with insurance companies. If I have a problem with a drug, I don't get some receptionist that assumes the responsibility of practicing medicine and pretends like the prescriber authorized something. At a hospital, I can just walk down the hall and talk to the hospitalist one-on-one. Believe me, physicians respect hospital pharmacists waaaaay more than they do retail pharmacists. I've had dozens tell me this to my face. And we actually do counsel patients. Coumadin teaching and other such crap...and when we counsel, they take us more seriously because they are in a hospital bed, not impatiently waiting to get home while you ring up their Doritos.

No, no. To hell with retail pharmacy. A rant on retail pharmacy wouldn't be 35 points long, it would be 35,000,000 points long.

 

[Glycerin]

Hey, yo... Do you still have your blog?

 

[WVUPharm2007]

Hey, yo... Do you still have your blog?

It's still there. Somebody needs to update it though.

 

[BADD281]

I really couldn't give two ****s about what a doctor thinks of me to be quite honest. How do you think all of these prescriptions every year get filled? It sure as hell ain't because of hospital pharmacists - its the CVS on the corner pumping out 800 - 1200 scripts/day. I'm not saying its perfect or even close to ideal but where would our healthcare system be without it? People take retail pharmacy for granted...

 

[WVUPharm2007]

I really couldn't give two ****s about what a doctor thinks of me to be quite honest.

I don't either, but it was asserted that such a thing would be a negative aspect of hospital pharmacy. I just disagreed.

How do you think all of these prescriptions every year get filled? It sure as hell ain't because of hospital pharmacists - its the CVS on the corner pumping out 800 - 1200 scripts/day. I'm not saying its perfect or even close to ideal but where would our healthcare system be without it? People take retail pharmacy for granted...

Please, we dole out 800 scripts before lunch. Just the IV pharmacist has his hands on 300+. The pharmacist that does cart fills has his hands on more individual orders in two hours than one retail pharmacist probably does all day. Of course, all of our orders are streamlined and the technicians do all of the busy work. We literally just make the final check. And we consider that entire part of the process the annoying part of our job that interrupts us from our real job; going out on the floor and monitoring therapy. In retail, putting tablets in bottles and calling insurance companies is quite literally the central part of the job.

And I do appreciate the idea of community pharmacy. However all we have is retail pharmacy...which is an insult to the possibilities of community pharmacy. CVS, Rite Aid, Wags, and whoever else; they are destroying your profession. They are turning pharmacists into script checking robots. They are capital driven corporations that are actually actively seeking ways to get rid of 6-figure pharmacists in favor of a 2-year educated certified pill-checker. Personally, I hope they can do it. Pharmacists should be initiating medication management programs (like the WV PEIA Face-to-Face DM management program, look it up), not spending all day making sure that's really lisinopril in the bottle and calling insurance companies. Any idiot can make sure the right drug is in the right bottle...and that's what retail pharmacy has degenerated into.

 

[BADD281]

I don't either, but it was asserted that such a thing would be a negative aspect of hospital pharmacy. I just disagreed.



Please, we dole out 800 scripts before lunch. Just the IV pharmacist has his hands on 300+. The pharmacist that does cart fills has his hands on more individual orders in two hours than one retail pharmacist probably does all day. Of course, all of our orders are streamlined and the technicians do all of the busy work. We literally just make the final check. And we consider that entire part of the process the annoying part of our job that interrupts us from our real job; going out on the floor and monitoring therapy. In retail, putting tablets in bottles and calling insurance companies is quite literally the central part of the job.

And I do appreciate the idea of community pharmacy. However all we have is retail pharmacy...which is an insult to the possibilities of community pharmacy. CVS, Rite Aid, Wags, and whoever else; they are destroying your profession. They are turning pharmacists into script checking robots. They are capital driven corporations that are actually actively seeking ways to get rid of 6-figure pharmacists in favor of a 2-year educated certified pill-checker. Personally, I hope they can do it. Pharmacists should be initiating medication management programs (like the WV PEIA Face-to-Face DM management program, look it up), not spending all day making sure that's really lisinopril in the bottle and calling insurance companies. Any idiot can make sure the right drug is in the right bottle...and that's what retail pharmacy has degenerated into.

You know... you and I do not agree on much but I have to say that some of what you say is correct. Our state legislature is pushing for the technician-ish position that you speak of right now as you speak. I really don't know what to think about that - seems like a lot of liability to me for the companies (especially when misfilled scripts are getting national headlines regularly now..). My school is all about pharmaceutical care. Everything we talk about is revolved around providing patients pharmaceutical care and its very clear that they do not want us to go the retail route (very much implied). I'm sure you have heard of the Ashville Project, well its pretty much the basis of one of my classes (Introduction to Pharmaceutical Care) and I have to say it seems very rewarding to work with people above and beyond just yelling out their last name in the waiting area..I have debated about what I want to do with my degree and honestly I feel like I would rather do clinical (in my heart), believe it or not WVU. I just don't know how I am going to pay my loans since a lot of these jobs do not pay as much as retail..and I also just like playing devil's advocate because I have received nearly all of my pharmacy experience in retail which makes me very inclined to defend it, even when sometimes I know everything you say is true.

 

[Glycerin]

I just don't know how I am going to pay my loans since a lot of these jobs do not pay as much as retail

I know of plenty of hospital jobs that pay close to or more than 100K/year, but let's just throw out a lower salary just for the hell of it. Say you make 80K/year. If you can't pay off your loans even making that, you've got some issues.

 

[Requiem]

I formally request your top X# of things you hate about retail pharmacy.

 

[BADD281]

I know of plenty of hospital jobs that pay close to or more than 100K/year, but let's just throw out a lower salary just for the hell of it. Say you make 80K/year. If you can't pay off you loans even making that, you've got some issues.

I'll have $200K by the time I graduate... $80K would be pretty tough.

 

[Glycerin]

I'll have $200K by the time I graduate... $80K would be pretty tough.

So will I, and so will a lot of us. I'm not worried at all. You just spread it out and pay more than the minimum amount and more often when you can. Debt is a part of life.

 

[tussionex]

I formally request your top X# of things you hate about retail pharmacy.

everything.

work for IT.
😀

 

[WVUPharm2007]

The salary difference isn't that big anymore. I know a fellow that is raking in $115k in Eastern Kentucky at a hospital. I'm only at $90k + $5000/year bonus, but I've got more than enough to pay back my loans. They let you pay it off over 30 years if you so please.

 

[BADD281]

Whoa 30 years? I thought it was only 10?.. Well that certainly changes things. I can deal with 30, heck I my original plan was to aim for 5 years, while working like a slave and living in townhouse or something...

 

[ItsOverZyvox]

I just hired an ID pharmacist at $115K.

Hospital base salary is very misleading. There are evening, night, and weekend differentials and on call pays.

 

[ItsOverZyvox]

32) Xopenex.

33) Physicians who refuse to let me switch someone to albuterol from Xopenex.

Ask the physician why they think Xopenex is better. When they reply "safey" show them the Package Insert... the Adverse Drug Reaction section which shows identical ADR rate for Albuterol and Lev-albuterol.

Also ask them what's the difference between Albuterol and Lev-albuterol.

If they answer correctly, then ask them what's causing the tachycardia.. S or R albuterol... if they answer correctly, then tell them.."hmmm.. same identical active compound but one is safe and the other is not?"

Then ask them about physiological effect of S-albuterol in the recemic mixture...

 

[WVUPharm2007]

Ask the physician why they think Xopenex is better. When they reply "safey" show them the Package Insert... the Adverse Drug Reaction section which shows identical ADR rate for Albuterol and Lev-albuterol.

With those "types" of practitioners, if I tried to get that far, they'd just run off.

Also ask them what's the difference between Albuterol and Lev-albuterol.

If they answer correctly, then ask them what's causing the tachycardia.. S or R albuterol... if they answer correctly, then tell them.."hmmm.. same identical active compound but one is safe and the other is not?"

Then ask them about physiological effect of S-albuterol in the recemic mixture...

If you've ever gotten that far, I commend you.

 

[Priapism321]

At my previous institution, it took one well known PharmD and one Physician in the areas of pulmonology/immunology to get that far with the P&T Committee. Three words, non-formulary, NOT AVAILABLE, automatic interchange to albuterol (or was that 7 words?). That is as far as levalbuterol got.

 

[ItsOverZyvox]

With those "types" of practitioners, if I tried to get that far, they'd just run off.



If you've ever gotten that far, I commend you.

hmm.. I guess that's why hospitals pay big bucks for consultants.
And as long as you and your pharmacy staff and director fail to "get that far" I'll have a job..

 

[ItsOverZyvox]

At my previous institution, it took one well known PharmD and one Physician in the areas of pulmonology/immunology to get that far with the P&T Committee. Three words, non-formulary, NOT AVAILABLE, automatic interchange to albuterol (or was that 7 words?). That is as far as levalbuterol got.

Good Lord.. any 4th year PharmD "Candidate" can give that talk..

Am I safe to say most pharmacists are incompetent in practicing pharmacoeconomics based on clinical pharmacy practice????

It's simple chit! Same chit.. one costs 28 times more.. let's use the one that costs less. How hard is that???

 

[Priapism321]

Good Lord.. any 4th year PharmD "Candidate" can give that talk..

Am I safe to say most pharamcists are incompetent in practicing pharmacoeconomics based on clinical pharmacy practice????

It's simple chit! Same chit.. one costs 28 times more.. let's use the one that costs less. How hard is that???

Believe me, it didn't take much, but when an Attending requests the addition of a drug to the formulary, a process has to take place. All drugs get reviewed, and an evidence based, objective summary is prepared and presented to the committee. And they vote. It helps if you have "experts" on the rational side of the argument to convince some committee members; 4th year pharmacy students may not work. Same process has led to dexmedetomidine being requested 3 times in 5 years, and it being denied 3 times (for all indications, ICU and OR, not available in the building). Can you top that?

 

[WVUPharm2007]

This is why pharmacy is also an art. All of us know Xopenex is ****. It's parlaying all of the people with more power than you and scientific data into a cohesive unit of rationality that's the tough part. See, we have it on the therapeutic subs list. But the dummies can just get around it by writing "DO NOT SUBSTITUTE" on the prescription. P&T committees are only as strong as their ability to not let physicians have loopholes to prescribe poorly. You can tell them that albuterol won't make the guy with a-fib throw a clot or whatever the hell...but they will just say, "well, I'd like to play it safe and give them Xopenex." End of story. Bull**** wins.

 

[ItsOverZyvox]

Believe me, it didn't take much, but when an Attending requests the addition of a drug to the formulary, a process has to take place. All drugs get reviewed, and an evidence based, objective summary is prepared and presented to the committee. And they vote. It helps if you have "experts" on the rational side of the argument to convince some committee members; 4th year pharmacy students may not work. Same process has led to dexmedetomidine being requested 3 times in 5 years, and it being denied 3 times (for all indications, ICU and OR, not available in the building). Can you top that?

Yes I can... I actually wrote the position statement for Dex that went out to like a lot of hospitals to prevent it being added to the formulary.

And every hospital I go to, Xopenex gets killed. But the first presentation I gave to a P&T years ago was written by a 4th year student. That document actually got incorporated into a position statement.

Actually, different issues require different expertise and it helps to have experts on your side. But Levalbuterol is a very elementary topic.

 

[ItsOverZyvox]

This is why pharmacy is also an art. All of us know Xopenex is ****. It's parlaying all of the people with more power than you and scientific data into a cohesive unit of rationality that's the tough part. See, we have it on the therapeutic subs list. But the dummies can just get around it by writing "DO NOT SUBSTITUTE" on the prescription. P&T committees are only as strong as their ability to not let physicians have loopholes to prescribe poorly. You can tell them that albuterol won't make the guy with a-fib throw a clot or whatever the hell...but they will just say, "well, I'd like to play it safe and give them Xopenex." End of story. Bull**** wins.

ehh...there is one more step to it. Those physicians who abuse DNS should be reviewed. You should collect all Xopenex DNS orders than single out the docs who abuse it. Take it to the P&T and those physicians must be present to defend themselves..clinically...which they can't.

Then take it to the Med Exec committee...and have the medical director and the administrator have a chit chat with the offending physician and how much money that physician is consting the institution, unnecessarily.

 

[Priapism321]

Actually, different issues require different expertise and it helps to have experts on your side. But Levalbuterol is a very elementary topic.

Those were my thoughts exactly. Honestly, it never stood a chance where I came from, but the process had to occur.

That is pretty impressive on the dexmed.

 

[ItsOverZyvox]

Those were my thoughts exactly. Honestly, it never stood a chance where I came from, but the process had to occur.

That is pretty impressive on the dexmed.

Unfortunately, most DOP and Clinical Managers would rather hide in the pharmacy and let everyone have everything than be confrontational, diplomatically. Everyone wants a job...but no one really wants to work that hard.

 

[WVUPharm2007]

Then take it to the Med Exec committee...and have the medical director and the administrator have a chit chat with the offending physician and how much money that physician is consting the institution, unnecessarily.

Ok. You are in the rust belt. Most people don't want to work there, anyway. The physicians you have given privileges to..well... you can't believe that you have. They are like little mini-dictators that aren't questioned too much because they are "needed." The hospital admins have no balls and let them have an incredibly loose leash. Then what?

 

[ItsOverZyvox]

Ok. You are in the rust belt. Most people don't want to work there, anyway. The physicians you have given privileges to..well... you can't believe that you have. They are like little mini-dictators that aren't questioned too much because they are "needed." The hospital admins have no balls and let them have an incredibly loose leash. Then what?

You hire us. The consultants. If your hospital folds financially, where will the physicians practice? Hospital needs docs and the docs need hospital. The docs need to have vested interest in the hospital's financial well being.

Trust me...I work with hospitals 100X more rural than yours.

You just have to learn to talk to your docs and earn their respect. You could be the guy who makes the difference in your hospital..if your DOP and the adminstrators aren't willing.

 

[WVUPharm2007]

You hire us. The consultants. If your hospital folds financially, where will the physicians practice? Hospital needs docs and the docs need hospital. The docs need to have vested interest in the hospital's financial well being.

There are about 5 hospitals within a short drive all of which need people bad. Including WVU, which has one hell of a nice institution. I don't think they'd care...they'd move...