tompharm

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So I know I ask random questions on this board but I just got hired at this independent pharmacy and worked my first full day today.

They just opened this pharmacy back in March and I was told that it was open by the same name in another area for 5 to 6 years which I can verify it on google, just not when it was opened.

I was introduced to the other pharmacist yesterday and he showed me how things were done there. He seemed confident that everything there was ok and nothing was going on.

So, a big problem with this pharmacy is that there is a pharm tech that does everything like she is the pharmacist.... I don't know if that is typical but she verifies all the CIIs and puts the ICD-9 codes on them.

Basically, I think it is a pill mill... they are only doing about 10 Rxs a day and they are all like CIIs.

Like I said I don't feel right about the place but its hard for me to judge if there is anything wrong with it.

I mean all the CIIs are valid, and verified. Most of the patients are from the area and have filled there before.

I had one guy come in who has a address and Rx from about 150 miles away. I filled his Rx, I didn't think about it til after the fact.... but the biggest reason I filled it was because the tech insisted that he has been there before and it wasn't a problem.

So, I was thinking about staying there a few months then getting the f outta town, I just wanted to hear what other people think about this.
 
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tompharm

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Can anything happen to me as a pharmacist if I fill prescriptions that have been verified with the doctor, have ICD-9 codes on them and written on a legit prescription? Would the DEA come after me if I fill a prescription that was outside my county or if everyone comes in a pays with cash?
 

pezdispenser

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Yep, sounds like a pill mill. There are lots of independent pharmacies like this in Florida. So the tech does everything and you're just there because they need someone with a pharmacist license? Did they also entice you to become the pharmacy manager? What happened at their previous location? Look up the pharmacy license on the board website.

If you only do C-IIs, the DEA will very quickly flag this through the purchasing records from your wholesaler and come and investigate.

Verifying the scripts means nothing. The doctors are real. The scripts are real. But how do you know whether the patient is selling their pills on the street? There are people who started taking narcotics, then found out that they could sell their Roxi on the streets for $5,000. Suddenly they have a good reason to continue being in pain and to keep going back to the doctor for more. They know the rules. Take a couple of pills so it shows up in the urine test. Go exactly once a month. Never early. Pays in cash so there is no insurance record. Doesn't flinch when you tell them the cash price is $1000+. In fact, your pharmacy probably already has a set price per pill to tell everyone who calls. Once they find a pharmacy stupid enough to take them in, they've hit the jackpot, because they can continue filling as a regular patient.
 

extra07extra

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If scripts is real and doctors is real why does it matter? I just do my job as pharmacist and fill prescirption, why care what patient do with drug? they go sell on street they dont effect me. they script have icd9 code and not early so yourself is covered.
 

Old Timer

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If scripts is real and doctors is real why does it matter? I just do my job as pharmacist and fill prescirption, why care what patient do with drug? they go sell on street they dont effect me. they script have icd9 code and not early so yourself is covered.
Because you have a legal obligation to ensure the rxs are for a legitimate medical need and if their not, you can get in a ****load of trouble.....
 
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If scripts is real and doctors is real why does it matter? I just do my job as pharmacist and fill prescirption, why care what patient do with drug? they go sell on street they dont effect me. they script have icd9 code and not early so yourself is covered.
What pharmacy do you work at? I have a whole bunch of scripts I suddenly need filled...
 
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Ackj

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Because you have a legal obligation to ensure the rxs are for a legitimate medical need and if their not, you can get in a ****load of trouble.....
Thankfully I practice in an area where I don't see a lot of the issues that are going on in Florida, so I'll admit I don't have much practice scrutinizing C2s. If it's a valid doctor providing you with an ICD9, what more would you want? For the sake of argument, let's say this isn't a patient coming from out of state with all of those other red flags, but simply someone you haven't filled for before. As someone who has been in the trenches longer than I've been breathing, I'm curious what you would need before you're okay with filling for them.
 
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tompharm

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It looks that way, yeah I really don't have a good feeling. I was hoping as the day went on it would get better such as filling for more non- controls but as I sat there I heard phone call after phone call looking for dilaudid 4 mg and I got a really bad feeling about everything.

Ironically, they did ask me if I wanted to become pharmacy manager the same day they hired me. This is right after they told me they weren't going to pay me that much because I didn't have any experience.
 
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It looks that way, yeah I really don't have a good feeling. I was hoping as the day went on it would get better such as filling for more non- controls but as I sat there I heard phone call after phone call looking for dilaudid 4 mg and I got a really bad feeling about everything.

Ironically, they did ask me if I wanted to become pharmacy manager the same day they hired me. This is right after they told me they weren't going to pay me that much because I didn't have any experience.

I would leave while you still have a license.
 
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tompharm

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I think I am going to go up there on Monday and call it quits. I guess this will probably be the end of my very brief pharmacy career, one day worked lol. I'm going to keep trying to get in with a chain or hospital but I don't think it's going to work out for me.
 
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Old Timer

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Thankfully I practice in an area where I don't see a lot of the issues that are going on in Florida, so I'll admit I don't have much practice scrutinizing C2s. If it's a valid doctor providing you with an ICD9, what more would you want? For the sake of argument, let's say this isn't a patient coming from out of state with all of those other red flags, but simply someone you haven't filled for before. As someone who has been in the trenches longer than I've been breathing, I'm curious what you would need before you're okay with filling for them.
After a while it's not hard. After all how many under 30 y/o need Oxycontin 30 mg and nothing else? The doctor is a "Pain Specialist" When the doctor writes the same things over and over and doesn't write much else, you can assume it's not a legitimate medical purpose. I only fill Oxy 30 if it's from an Oncologist or a University Pain Center. I also look at their entire profile. Neurontin, Cymbalta something. It is rare that a person has so much pain they need Oxy 30's on a regular basis and have no other concomitant medical conditions. They also better live near me and not in east Jipip.....
 

StellargalS

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If scripts is real and doctors is real why does it matter? I just do my job as pharmacist and fill prescirption, why care what patient do with drug? they go sell on street they dont effect me. they script have icd9 code and not early so yourself is covered.
If scripts is real and doctors is real why does it matter? I just do my job as pharmacist and fill prescirption, why care what patient do with drug? they go sell on street they dont effect me. they script have icd9 code and not early so yourself is covered.

Ummmm. Somebody help me understand.

 
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YourMD

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Definitely a pill mill! If the pharmacy ensures they have a decent control to non control ratio I would stick it out until you find something else. Student loan payments are a [email protected]#H! However, If they are frivolously filling for patients with only control profiles I would get out of dodge Quick! No license is a hell of a lot worse than no job. Goodluck!

What county do you work in?
 
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tompharm

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Another reason I thought it was legit because they told me they were waiting for medicare/Medicaid to get more business.
 

extra07extra

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Because you have a legal obligation to ensure the rxs are for a legitimate medical need and if their not, you can get in a ****load of trouble.....
I mntion doctor is real, script is real why worry?? you just fill script and give drug to patient. I never have any problem before I just keep pharmacy happy and keep filling script. Doctor prescribe drug, I fill drug, patient get drug. Everybody win!
 
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It's definitely a pill mill. I worked for a similar pharmacy for 3 months right after school. I took the job because I didn't want to relocate (my husband has a better job where we live). I knew it was going to be temporary after the first day. The tech wanted to control everything because they knew I was a new grad. I didn't let her and so we were enemies for the first 2 weeks and then we became friends. In the 3 months I was there, the first thing I did every morning before going to work was get on indeed and apply to as many jobs as possible. I was relentless. I had multiple phone interviews right there at work. Fortunately, I got an offer from Walgreens right at the 3 months mark. I quit the day I received my offer letter from Walgreens.
So I say stay while you look for another job. Try as much as possible to protect license. The only person that decides what gets filled should be you and not the tech. They can make that decision when they get their own license. Limit how many controls you do in a day (high volume attracts attention) and just put effort into getting another job. Good luck!
 

Aznfarmerboi

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If you have to ask the question, it is a pill mill. Leave asap.

Even if the script and doctor is legitimate, you can still get into a lot of trouble filling it. As RPH, you have a corresponding responsibility to make sure scripts are being filled for a legitimate purpose, by a prescriber in his usual course of practice. There are many doctors who are pill pushers. If you suspect the purpose of the script is for the customer to sell or abuse it, you should not fill it.

Scripts are suspicious if its written for a high dosage or high quantity, if the customer is paying cash, if customer or MD is from far away, if there are no co-meds (ie lyrica, gabapentin, Cymbalta, etc), early refills, etc.
 
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rph3664

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I think I am going to go up there on Monday and call it quits. I guess this will probably be the end of my very brief pharmacy career, one day worked lol. I'm going to keep trying to get in with a chain or hospital but I don't think it's going to work out for me.
Believe me, any pharmacy in your area would understand why you left after just a short time.
 
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tompharm

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So I know the DEA investigates Pharmacies about once a year. Will the DEA just strip the pharmacy of its license if it suspects foul play?
 
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tompharm

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Doesn't having an icd-9 code make the Rx legitimate?

"To be legitimate, a prescription must be issued by a practitioner acting in the usual course of their professional practice and it must be used for a legitimate medical purpose. This limits dentists to prescribing medications for treatment of medical conditions of the mouth, teeth, and gums and veterinarians to treatment of animals. The pharmacist who dispenses the prescription also has a responsibility that the medication is being used for an appropriate reason. Prescriptions must be written for a specific individual; they can't be written for a prescriber to use as "stock" to dispense from an office setting. If these criteria aren't met, the prescriber and/or pharmacist may be subject to criminal or civil penalties or administrative sanctions."
 
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tompharm

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Is there anyone I can call to find out if the stores policy and procedures is ok and if verifying with ICD-9 codes is ok?
 

Gombrich12

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I have to laugh at the thought of you explaining to the DEA that you thought filling 10 scripts all day, that happened to be pain medicines, and always for cash was normal. What the hell do you do all day, and why are they even having this place open more than like 2 or 3 hours tops?
 
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tompharm

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They said they are waiting on their Medicaid/medicare
 

Ackj

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I have to laugh at the thought of you explaining to the DEA that you thought filling 10 scripts all day, that happened to be pain medicines, and always for cash was normal. What the hell do you do all day, and why are they even having this place open more than like 2 or 3 hours tops?
This is a great question. You have a tech who does everything and you fill 10 per day. What do you do?
 
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tompharm

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Not a lot, just sit and wait. I don't know I only worked there one day so far. I'm only working there prn. I just want to work there for 10 work days then I'm going to quit.
 
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tompharm

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I heard some stuff about that pharmacy yesterday from a pharmacist that used to work there. So I went up there and quit this morning.
 
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knight on horse

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Hahaha, Oh Florida

Just wish I had spent more time with the babes there earlier in the decline