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Local Wags pharmacists not doing the job..
Started by ZpackSux
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Same with CVS here...👎
It seems no pharmacist offer counseling these days. Maybe..
It seems no pharmacist offer counseling these days. Maybe..
In my opinion, this is retail pharmacy at its best!!
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I always offer counseling. It's surprising how few patients want it. Especially at the drive-thru where all they have to do is push the button and the meds pop out - all in the name of convenience.
So it's easy to blame the retail pharmacist for not doing his job, when really it's the synergistic relationship between consumers pressuring for convenience and the profit motive of corporations that have brought things to this point.
If I had my way, I'd close every single retail pharmacy. Let Walgreens and CVS do what they do best, sell meaningless crap to consumers. Let the pharmacists open their own shops to do what they should be doing - taking care of patients.
So it's easy to blame the retail pharmacist for not doing his job, when really it's the synergistic relationship between consumers pressuring for convenience and the profit motive of corporations that have brought things to this point.
If I had my way, I'd close every single retail pharmacy. Let Walgreens and CVS do what they do best, sell meaningless crap to consumers. Let the pharmacists open their own shops to do what they should be doing - taking care of patients.
When you pickup a prescription, you should be offered the opportunity to speak to a pharmacist. The way CVS stores are designed, the pharmacist is never out of view of the customer. If you have a question ask to speak to the pharmacist. If you leave the store and have questions, call the pharmacist. I personally place notes on the label if there is something I want to discuss with the patient such as change in dosage or therapy or hospital discharge prescriptions. It's not the chain stores it's the pharmacists.....
The tech sometimes ask "Do you have any questions?"
Does that count as "offer counseling"?
After the 20/20 show, I went to ask the tech what Im signing for. He says It's to confirm that I received my prescription. lol
Does that count as "offer counseling"?
After the 20/20 show, I went to ask the tech what Im signing for. He says It's to confirm that I received my prescription. lol
For all the prescriptsions I've picked up for my wife and kids, I've never talked to a pharmacist. I've been asked about allergies a couple times (when picking up abx), asked if I had any questions. I don't think I've ever been asked if I wanted to speak the the Rph.
Bingo!
I don't work for either, but I'd guess that in their corporate P&P it notes that every new prescription requires counseling, unless picked up by someone other than the pt him/herself.
Now....we all know those pharmacists who can't maintain social conversation let alone do counseling (& wonder how they every got into pharmacy school???). We also know of those technicians who feel they can give out any d*mn thing they want & bypass the pharmacist entirely.
So - yes...it will take a few complaints to the state board. After enough of those & a lawsuit or two....things will change - but only a bit.
Periodically, the state board publishes the complaints, the # substantiated & the fine paid. The smallest fine is $500 - the largest is $2500 (for '05-'06). All of the $2500 fines involved death secondary to a pharmacy error, so you know there was also a malpractice lawsuit filed as well.
It is ABSOLUTELY the pharmacist's job to make sure that on his/her shift all employees know that NO new rx goes out without the pt being counseled or a verifiable & noted reason why not (picked up by someone other than the pt).
You can make a complaint to the Texas state board......or to the Wags main corporate office in Texas with a cc to the Texas Pharmacist Association. Who better than a pharmacist to criticize poor pharmacy practice when it is encountered???
No - the tech cannot ask if the pt has questions because there are some things the pt does not even know to ask - hence the pharmacist counseling.
Yes - most sig cap machines now only document the picking up of the medication.
After the 20/20 incident, most counseling options have been now shut off on the sig caps.
Legally, in CA you cannot be counseled on your wife's rxs unless she gives specific permission.
However, you should have been counseled on your children's - if they're under 18. It pisses parents off when I won't counsel on an 18 yo, but I respect their adult status.
My mother-in-law used to get upset when Kaiser wouldn't discuss her son's ADD condition, meds, etc over the phone after he turned 18. Her beef was that her insurance was paying for it. She got over it though, eventually.
When I was a student affairs administration at a small women's college, I'd have parents absolutely irate with me because I couldn't discuss their daughters' grades or activities with them. Or let them into the dorm to check up on their kids. The parents' argument was that they were paying the tuition and should call the shots. But higher education has its own HIPAA - it's called FERPA (Family Educational Rights and Privacy Act) which precludes disclosure of such information for a student of legal age.
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In the Commonwealth of Pennsylvania, only the Pharmacist may counsel a patient. The offer to counsel can be made by anyone on the pharmacy staff. Each and every time you pick up a prescription you must be offered the option of receiving counseling. The offer should be made by saying, "DO YOU HAVE ANY QUESTIONS FOR THE PHARMACIST?
As I said earlier, if there is a reason to counsel a patent, I always either ask the patient to step to the consultation booth if they are waiting or place a note on the bag to ask them to speak to the pharmacist when they pick up there prescriptions.
Don't give me the I'm too busy line. You are never too busy to speak to a patient. I have worked as a pharmacist for 25 years in volumes as low as 700 per week and as high as 3000 per week and I always speak to my patients. It's up to you as a pharmacist to practice pharmacy not pill dispensing.
As I said earlier, if there is a reason to counsel a patent, I always either ask the patient to step to the consultation booth if they are waiting or place a note on the bag to ask them to speak to the pharmacist when they pick up there prescriptions.
Don't give me the I'm too busy line. You are never too busy to speak to a patient. I have worked as a pharmacist for 25 years in volumes as low as 700 per week and as high as 3000 per week and I always speak to my patients. It's up to you as a pharmacist to practice pharmacy not pill dispensing.
If the pharmacist needs to counsel a patient at Wags, when the tech rings it up it will say Consult RPH and they can't cash out the patient. All new scripts prompt you on the cash register display to ask the patient about counseling. Since I'm still an intern, I always explain it whether they want it or not.
Well I haven't received formal training yet, but from my experiences at the local pharmacy, I can tell you that it seems pretty lazy to simply ask "do you have any questions?" It's kinda like the waitress asking "Is everything okay?" before I have had a chance to take a bite.
I think I would take a different route, such as "make sure you take that with a full glass of water", "make sure you shake those drops well", or "don't take that on an empty stomach."
Employing such a practice would not only reinforce the "typical" information to the patient, it would open the door of communication more effectively.
Besides, I like to hear myself.
I think I would take a different route, such as "make sure you take that with a full glass of water", "make sure you shake those drops well", or "don't take that on an empty stomach."
Employing such a practice would not only reinforce the "typical" information to the patient, it would open the door of communication more effectively.
Besides, I like to hear myself.
I think this is all very dependent on the pharmacist's attitude towards counseling. At the Walgreen's I work as an intern, every patient (new prescription) is told that the pharmacist will be right over to counsel them. Sometimes the patients say no they don't need any info and most of the time they agree. On refills/transfers we ask if the patient has any questions. We make sure no new prescription leaves without the patient being counseled unless they refuse counseling. Of course on drugs such as antibiotics I make sure to counsel even if it is a refill just to make sure they are taking it correctly.
I don't give a rat'z arse if pharmacist is too busy or not...there is no excuse for not counseling a patient unless the patient declined it..and it's documented. Can a physician use that excuse when a consult is requested?
"I'm too busy to consult."
That's not any different than "I'm too busy to counsel."
Pathetic. 👎
"I'm too busy to consult."
That's not any different than "I'm too busy to counsel."
Pathetic. 👎
Non counseling Pharmacists need some discipline. Maybe a fine/suspension.
And the companies providing non-conducive environment for the pharmacists to perform their duties should face discplinary actions.
👍👍👍
But - to the corporations benefit, I'd offer there are many, many pharmacists who "hide" behind the counter & their perception of "being too busy" & want nothing more than to lick & stick. I've worked with some & sadly they have nothing to offer the patient or the profession.
Walgreens and CVS are mail order pharmacy with all the distractions of retail. The Pharmacist does not have time to go to the bathroom, eat lunch or take breaks let alone stop verifing scripts to talk to someone. Try and call then for a transfer sometime, its usally a 20 minute wait on hold.
To be fair as well, I think Walgreens is the worst place to work as a Pharmacist. However, most people who go to Walgreesn or CVS could give a Rats A$$ about counseling. They want fast food pharmacy, their way, right away, right now. Honestly, I think the company as a whole promotes that. They do not want their pharmacists to counsel. Ask any current Wags pharmacist about the green, yellow and red pie graphs on the computer keeping track of their ready rate and scripts per hour. There is nothing keeping track of how many people you counsle or how many questions you answer.
To be fair as well, I think Walgreens is the worst place to work as a Pharmacist. However, most people who go to Walgreesn or CVS could give a Rats A$$ about counseling. They want fast food pharmacy, their way, right away, right now. Honestly, I think the company as a whole promotes that. They do not want their pharmacists to counsel. Ask any current Wags pharmacist about the green, yellow and red pie graphs on the computer keeping track of their ready rate and scripts per hour. There is nothing keeping track of how many people you counsle or how many questions you answer.
Doctors do it all the time there Z. I hear from patients all the time that the Doctor was to busy to answer question or their appointment was to short ect. It happens to all in Healthcare. Most Doctors have to see a patient evey 15 minutes all day everyday just to make it. I know several physicians here in town who have over 4000 active patients. How much attention are they giving their patients. I doubt they sit around and talk to each one for an hour and answer all their questions.
Not at any store that I have been at. I have been with CVS for six years and I have never been deprived of the bathroom in a timely manner. I do however plead guilty to not giving transfers the priority over people who are waiting. I DO NOT keep people on hold however, If I will be delayed in giving the copy I either ask the other pharmacist to call back or I get their number and call back.
At CVS, the blue sheets that everyone signs when picking up their prescription either declines or requests counseling. It's all documented. If they sign to the right, they're requesting counseling. To the left means they're declining counsel. Most don't read what they're signing though. It's there, and the offer is documented. However, I agree that it should still at least be verbally offered...(even if people are too stupid to read what they are signing...).
I get copies out quick at Wags for everyone but CVS. CVS and their $30 gift cards for transfers, doing whatever they can to drum up any business, can sit on hold all day.
You thought I was a youngin? Nope... I'm one of those "non-traditional" students that spent 10+ years thinking about going to pharmacy school before I ever got around to it. 😀That's how it works at my store. The techs just have to ask if the patient has any questions for the pharmacist and they can decline counseling. Depending on which pharmacists we have on duty, some will make the attempt to counsel on all new scripts and some don't. It's unfortunate.
I agree! These companies should be encouraging (or forcing) their pharmacists to counsel. I doubt I will go into community pharmacy, but if I do, I will definitely not work for a company that doesn't support my choice to counsel patients!
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At the pharmacy I work at the tech asks if the patient has any questions for THE PHARMACIST. Generally, the patient then responds with an eyeroll and proceeds to inform me that they have been taking the medication for 15 years in a voice that insinuates I have insulted them.
Also, at the pharmacy I work at when the patient signs it is only used as documentation that they have received their prescription and information pertaining to how it was picked up (RPh's initials, relation to the patient, and whether or not they were counseled). In tiny writing they couldn't read without a magnifiying glass it does say that they are agreeing to pay if something happens with their insurance, but that's about it. Why is that funny?
20/20 says techs/pharmacist were supposed to explain when you have signed, it means you've agreed you don't want counseling. So...I thought it was funny because after the 20/20, they still continued to do what 20/20 pointed out (not mentioning about counseling) Im not familiar with the new protocol, I guess it has changed?
Here is AZ the patient doesn't have to sign anything, so that whole 20/20 thing is a bunch of crap as far as this state. We have to counsel on all new scripts, whether a new drug all together, new strength, new directions, etc. Techs do ask if the pt has any questions for the pharmacist, on everything picked up, at least well trained techs do. On new ones, they don't release them, bringing them over to the consult window where the pharmacist now has to document if the pt is counseled or not. I don't know what other states are doing, but that is how every Wags I have worked in here in Phoenix is operating. I am not seeing pt's miss counseling on new scripts, and they are being offered counseling every time they pick something up.
I am betting that Mrs. Zpac was asked if she had any questions, and she probably rolled her eyes and said "no, my husband is a pharmacist, but thank you." Then Mr. Zpac, asked her, "did you talk to the pharmacist", where she replied "no", and he was off on his lazy-retail-pharmacist tirade. Or maybe they just do things different down there in Texas. That is definately a possibility being that it is its' own country and stuff.
Where I work they sign a sticker so we can keep track of whether or not they have picked up their prescription and so we have the signature if there is a dispute as to whether it was picked up. They have to sign it whether or not they are counseled. There are two boxes on the sticker that say received or denied counseling, but that's it. If they ask what they are signing, we refer them to the tiny print on the sheet. I don't think everyone who works in a pharmacy in America was tuned in to that particular program so I'm sure they are still doing what they were doing before even though the tv said not to do it, however I'm going to have to guess that everyone is going to continue to follow the protocol dictated to them by their place of employment instead of changing things because 20/20 said to.
That is the main use of the signature log at my store too. I don't know how many times I've had patients call up and say, "I never got my so and so." And when we'd tell them that they picked it up on such on such a date, they have absolutely no memory of that ever occuring. So then we've had to dig up the sig log on that date, rummage through all the numbers, and show them that they did in fact sign for it.
I believe the insurances in my state require that the signature log is signed, so when audits come around, that is one of the things they look for; but I was never the insurance/audit tech so I'm not too familiar with the process. It seemed like I was always the find-the-patient's-signature-who-forgot-they-picked-their-script-up tech.
Well, you know the pharmacists and interns at CVS don't like it any better than you do, but we have no control over the coupons because that is a corporate decision.
Usually its for their Xanax, Vicodin or something of that sort. I love the look on their face when we pull out the third party log and show them their signature...PRICELESS
This is my first time working at a pharmacy (CVS), and we always ask new patients if they want to be counseled. Since I'm interning, I just like to throw out tidbits of information even if the person didn't ask for counseling. I do attest to the fact that the pharmacist I work with is so hardworking, he's always on the phone or counting pills or talking to a patient, that he never have time to go to the restroom or finish his food. He finishes breakfast at 1pm and his lunch at 7pm! We close at 9pm by the way. He always takes a quick bite between counting narcotics (because the vault is right by our counter to eat food). He does leave notes on the printout we give to patients (it's also to prompt the person giving the medicine to the patient if there's any problems or issues).
Like Walgreens never gives out gift cards for transfers. So that's a reason to treat a colleague with disrespect. Or maybe it's that CVS stock is up over 90% over the last three years while Walgreen's stock is only up 30%.
Walgreens doesn't do gift cards for transfers here in Tampa. We do have patients who tell us in advance that they are transferring over to CVS for the gift card, but they will be transferring back the next month. I had a Winn Dixie transfer where the pharmacist apologized first for taking up my time, but they had a gift card for groceries promotion going on.
Doing transfers is part of my job as an intern. What does stock have to do with anything?
We don't do gift cards for transfers in AZ. That is actually another reason that I like the company. We do very few transfers at all. Usually, Wags customers stick for time, they don't bounce around month to month playing the coupon game. If a patient wants to use CVS, that's great, just keep all your meds there so the CVS pharmacists can do their jobs. Gift cards work against patient safety and overall health by opening up the door for drug interactions that can't be caught through polypharmacy. They definately were not thought up by some pharmacist. The marketing expert that created them needs to be shot.
There have been times where corporate has sent out checks to people, whether they havn't used the company for a long time, or they had some type of complaint, and we run those through for a gift card when they bring in a new script. I have done that about 5 times in two years.
But you're right, I actually leave you on hold because of the stock.
Every chain in N CA does some kind of promotion. It may not be a gift card, but its a coupon in the throw away section of the newspaper or delivered in their mail.
Its part of the job & I get an "official" reason to chat with my colleagues in the area. We all pretty much make sure to do that because we rely on each other for out of stocks sometimes & its a good time to get caught up on issues we share. We pretty much know exactly why these folks are doing it, so its no problem.
I especially like when I have to transfer into or out of state - then I'll really take time to talk. I've got some regulars who go to AZ in winter & a few who go to HI a couple of times a year. Its fun!!
But, piano - your pharmacist is setting up a poor example for you! You can choose how you work & working without being given time for basic (& in CA REQUIRED BY LAW) things such as bathroom & lunch breaks is just bad - professionally & personally.
As a matter of fact, 4 chains in my area are paying daily fines to the CA Dept of Labor. Each has been caught with lunches that were less than 30 min & not within the required hours (no less than 3.5hr & no more than 4.5hrs if working 6 or more continuously). So, after the initial fine, each "clocking" is being recorded & they are fined daily for each violation until their "probation" period is over. It runs into the hundreds of thousands of dollars - ouch! That cuts into the stock.
Its part of the job & I get an "official" reason to chat with my colleagues in the area. We all pretty much make sure to do that because we rely on each other for out of stocks sometimes & its a good time to get caught up on issues we share. We pretty much know exactly why these folks are doing it, so its no problem.
I especially like when I have to transfer into or out of state - then I'll really take time to talk. I've got some regulars who go to AZ in winter & a few who go to HI a couple of times a year. Its fun!!
But, piano - your pharmacist is setting up a poor example for you! You can choose how you work & working without being given time for basic (& in CA REQUIRED BY LAW) things such as bathroom & lunch breaks is just bad - professionally & personally.
As a matter of fact, 4 chains in my area are paying daily fines to the CA Dept of Labor. Each has been caught with lunches that were less than 30 min & not within the required hours (no less than 3.5hr & no more than 4.5hrs if working 6 or more continuously). So, after the initial fine, each "clocking" is being recorded & they are fined daily for each violation until their "probation" period is over. It runs into the hundreds of thousands of dollars - ouch! That cuts into the stock.
Sav-On has a new computer system that requires a pharmacist's or intern's fingerprint to be scanned for every new prescription. As a bonus, a screen with additional counseling info, a picture of each pill, etc, pops up. It has really helped with the counseling process. I've worked with some techs/pharmacists that are a little lazy and just say "I need verification" and have the pharmacist run over and smack their finger down without looking at the script. But most of the rph's that I've worked with actually take the chance to do a quick final check and to counsel the patients/ask them a few questions. Sometimes things can get a bit harry when we're busy because of the extra time it takes, but in general, the patients haven't minded (most of them get a kick out of the new high-tech computer system).
I actually like running the register now because of this process. It's made me better at counseling, but I still rely on the pharmacist if I'm unsure on anything about the drugs we're dispensing.
I worked at a CVS in Texas that did over 2500 scripts a week. We were also the #1 C-II store in the city of San Antonio. Most of the pharmacists there did hide behind the counter and only came out when prodded. Counseling through one of the three drive-through lanes? Forget it. And since there were also three registers, it was nearly impossible to maintain HIPAA privacy. Unfortunately, I saw several med errors made in just the 5 months that I worked there. I wouldn't ever want to work in a store with that high of volume. In fact, I really want to avoid CVS/Wag's in general - too many corporate policies that are about maximizing profits, not maintaining patient care and safety.
I actually like running the register now because of this process. It's made me better at counseling, but I still rely on the pharmacist if I'm unsure on anything about the drugs we're dispensing.
I worked at a CVS in Texas that did over 2500 scripts a week. We were also the #1 C-II store in the city of San Antonio. Most of the pharmacists there did hide behind the counter and only came out when prodded. Counseling through one of the three drive-through lanes? Forget it. And since there were also three registers, it was nearly impossible to maintain HIPAA privacy. Unfortunately, I saw several med errors made in just the 5 months that I worked there. I wouldn't ever want to work in a store with that high of volume. In fact, I really want to avoid CVS/Wag's in general - too many corporate policies that are about maximizing profits, not maintaining patient care and safety.
We do between 2300-2600 rx per week (CVS). We are open 24 hours and have 2 daytime pharmacists and of course 2 night time pharmacists. We have 5 full time techs, and 1 intern. We get 16 hours of overlap, thats it. Sometimes it is unbearable! We get so busy. Sometimes I cannot go to the bathroom! I never get a lunch and those stupid $25 dollar coupons! To the pharmacist who made the comment about leaving us on hold all day, I say thank you. Like it was my idea for those stupid coupons. A few of us in the area (CVS Pharmacists) have actually complained to corporate about these coupons; about how they promote unsafe practice. So please, dont take it out on us, we are just trying to do our jobs. Actually, I make it very difficult for patients to obtain the coupons or reedem the coupon. I dont want to transfer the RX just for a coupon, trust me I dont!!!
Anyway, I make every effort to talk to patients and try to use my staff (interns) as much as I can. I use my techs for ins problems (sometimes pt's will ask to talk to me about ins, but i just dont get involved with that, i let my techs deal with that!). I need to free myself up to talk to people, but sometimes we are so ridiculously slammed (4 pharmacy calls, 2 doctor calls, 2 drive up calls, 2 consults😱😱)....but i always do my best for the pt! Anyway, hopefully those darn coupons will go away!
Dr.M
Anyway, I make every effort to talk to patients and try to use my staff (interns) as much as I can. I use my techs for ins problems (sometimes pt's will ask to talk to me about ins, but i just dont get involved with that, i let my techs deal with that!). I need to free myself up to talk to people, but sometimes we are so ridiculously slammed (4 pharmacy calls, 2 doctor calls, 2 drive up calls, 2 consults😱😱)....but i always do my best for the pt! Anyway, hopefully those darn coupons will go away!
Dr.M
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13-15 rx/hr with all that help & 16 hour overlap & still no lunch nor breaks? Sounds like disorganized chaos to me. Seems that 16 hours would let you get to the bathroom😕
Um, that 13-15 rx/hr would be true if you filled the same amount of rx's per day everyday! You dont fill the same amount everyday. On sat and sun, we do like 200-250 per day, which leaves 2000 rx for 5 days. On mondays we do over 500, tues we do 450-500, and wed thurs fri we do 400-450. We have overlap on Mon and tues, and the rest of the days its just 1 Rph. Also, the over nite fills like 50 -60 rx in 12 hours, and the day time does the rest, so avg 475-50=425 in a 12 hour period = about 35 rx per hour an avg. On mondays it may be over 500 in a 12 hr period. So, your 12-15 rx's/hr is not right and 5 techs on a monday is not much help in retail for a store that does over 500 on mondays and an avg of almost 450 on other days. Along with the tranfers and all the other "crap". Trust me, i run an effecient store, that when I took over the store, complaints are down to nil and and we are keeping our patients. Thanks
Dr. M
200 hrs of tech help is not enough by the way. We are budgeted for 275 hours but we are always under. It it hard to find good tech help for a store of this volume. 16 hours of overlap may seem like a lot but let me tell you, someone always catches me on the way that the darn restroom! 😡Anyway, again, maybe i got a bit offended by your chaos remark, but i guess you just have to work the store to see whats it like. Before I took over the store, i asked myslef how bad could it be? It is bad especially at night after 6pm with only 1rph and 3 techs and with 2 drive-ups, 2 drop off winsdows and 3 registers and always people lined up to dropoff and pickup. I could go on foreve, but i will stop here.
As they say......the devil is in the details & surely these details explain so much!
So - rather than chaos (I was not meaning to be offensive, some pharmacies are just that way - chaotic! .... oh - pharmacists too!), you've got understaffing.
Your goals are to keep your patients, hopefully - provide good pharmaceutical services to your patients (counseling) & prescribers (answering prescriber calls) & not get a UTI or develop beriberi or kwashiorkor😛.....
You've done really well by decreasing complaints (& hopefully, not increasing errors!). I agree, staffing tech positions is terrible - they are very, very hard to come by. However, when you get down to one pharmacist & 3 techs, why don't you decrease your "flow" so to speak? You cannot staff 3 registers, 2 drop off & 2 drive ups adequately with your current staff. So close a few so you only have open what you can staff. People don't want to stand in lines - they'll come back if you tell them to....or they'll take their rx elsewhere - might be better for you & them if that happened, perhaps.
What is the worst that could happen if you indeed decided to reduce the flow in, tell your folks the wait time will be longer....thus putting more fills on the night crew, which has fewer patient/prescriber interactions & control your life a bit??? Would CVS really ever know about it? Would your dm, if he/she came in even comment on it??
Not criticizing - just questioning......At the end of the day, CVS won't give a rat's *ss about you, but your patients may question why they trust you-if you make a mistake, you'll forever regret a misfill due to too high a volume (whatever profit is totally lost in a malpractice case) & you might live just a day or two longer with your family...??
In CA - our changes began with one person at a time...went to more, then a county association, then a state association & we battled both our state & national hospital & retail professional organizations over our right to be treated as the lowest bagger would be in Walmart. Its been a tough ride, but I'd do it again!
