New Policy at CVS: a warning from a current tech to pharmacists

Discussion in 'Pharmacy' started by Lopyswine, May 9, 2008.

  1. Lopyswine

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    To all of you pharmacists and future pharmacists. CVS has introduced a new program called Patient Care Intiative (PCI).

    This is a HUGE new program. Some new steps:

    1) With EVERY script we take from a customer we have to ask them if they want us to transfer scripts in from other pharmacies. We have to explain to them that its easier to for maintenance scripts to be all filled at the same pharmacy. We also have to explain that the pharmacist can better check interactions if they can see all medications together.

    2) With EVERY single diabetes/blood pressure/depression medicine (maintenance scripts), the pharmacist is REQUIRED to council the customer. This is the HUGE CHANGE. We used to just ask every customer if they have questions for the pharmacist, if no, they just get rung up and leave. If yes, they go the council window and speak with the pharmacist. This new program requires that the customer and pharmacist speak. It has already become a HUGE slow down factor for our store.

    I know that many of you will be excited at the prospect of more interaction with the patient, however while the pharmacist must leave his station every 5 minutes, things start to back up. The phone keeps ringing, MDs keep leaving messages, and we the techs continue to "line em up" to be checked.

    3) CVS is now following the lead of walgreens and calling and ASKING customers if they want us to auto-fill there refills.

    I think all of these factors may contribute to CVS slowing down the level of script filling and lead to more stress for the pharmacist. The positive side is that the pharmacist gets to play a more active role in the health care of the patients.

    Some stuff for you guys to think about.
     
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  3. PharmDstudent

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    CVSucks.

    Unless someone has a lot of money invested in their stock, I wouldn't suggest working there.
     
  4. Idesiretosling

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    You are going to hurt Oldtimer's feelings with that CVS bashing...
     
  5. nerv12345

    nerv12345 ...
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    this is the biggest waste of time in the universe. one of my coworkers spent HOURS on saturday making calls when she could have been contributing. no wonder it felt like such a long day even though we only did 150 scripts (there were only 3 of us working that day)
     
  6. MountainPharmD

    MountainPharmD custodiunt illud simplex

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    That it is!!! CVS officially sucks more than another retail chain!!!!! WHOOO!!!! HOOOOO!!! Way to go CVS.

    Can you imagine how bad things will suck now? It was bad when one pharmacist had to verify 500 scripts. Now they will do the same volume but have to go talk with every customer. Something has got to give. There is only so much that one pharmacist can do. I predict lots of mistakes and lots of unhappy pharmacists looking for a new job. I guess I better get ready for all the transfers from the CVS next door to us.
     
  7. azPharmD2B

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    Is this regional or nationwide?
     
  8. monsterbrain

    monsterbrain Drinking for sanity.

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    I don't know if CVS already does this but at Walgreens (at least in our district) we are required to call every single delete every night before we actually put the drugs back in stock. This is on top of the automated machine calling the same phone number twice in one week: first to say the script is ready, second to say it will be deleted if they don't pick it up. And yet, some big whig at corporate decided we would make a lot more money if we called AGAIN to remind them that their RX is ready :rolleyes:.

    I work in a high-volume, 24-hour store, and we usually have 25-30 deletes a night. Do you know how long it takes to call that many household??? Sometimes, several hours (in between doing real pharmacy stuff). And how many people actually will come in the next day to pick up their RX? About 2. I don't have a business degree, but how in the hell do they figure we are being more profitable with this enormous waste of time???
     
  9. Aznfarmerboi

    Aznfarmerboi Senior Member

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    For number 2, I am not sure how it is in other states, but in NYS, A pharmacist or a pharmacy intern MUST counsel the patient on any new drugs, change in strength, dosage, etc. In the old days, a pharmacist can allow a tech to ask if a patient wants counseling.

    http://www.op.nysed.gov/pharmqa703.htm

    Although I agree with you that this will be a headache, it is only headaches for techs. I dont see how the pharmacist will be affected. Furthermore, I dont see how CVS will punish you per se if you dont follow the rules.
     
  10. rxlynn

    rxlynn Senior Member

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    Nationwide, although I think that the roll-out of PCI is being done on a regional basis, so maybe they haven't started in your area yet. I have done basic training for this program, and I think the OP is pretty much right on target. This program is a huge new source of required reports and work for the pharmacy staff.

    I personally find stuff like this hard to swallow because I can pick up the trade journals and see how many millions of dollars a year CVS is supposedly making, yet PCI is being sold as a way for us to increase Rx volume (like most stores really need that, considering that the tech budget has just been cut again).

    I await Old Timer's thoughts on this new program.
     
  11. Knipps

    Knipps In a 6 year program

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    same way as if you don't follow the rules of any other job, termination.
     
  12. rxlynn

    rxlynn Senior Member

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    The pharmacist will be affected because the few techs that he or she has will be asked to spend a significant amount of time calling patients and filling out paperwork related to this program. For example, the store I was in today had the M-W call report that the program generates. That particular report for this week had a list of 19 affected Rxs. The PCI program requires a tech to make 3 attempts to call those patients, unless you can document that the phone # on file is incorrect. For this particular list, you are not supposed to leave a message. So, that's 57 phone calls on top of all the normal activities that the techs have to do.
     
  13. Farmercyst

    Farmercyst From the shadows
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    Isn't this just OBRA90?
     
  14. Farmercyst

    Farmercyst From the shadows
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    I think they're right as far as money making and allowing the pharmacist to be more involved with patient communication, but as stated, it's benefits would be more readily realized if they actually hire sufficient personnel to prevent the stress related issues. I don't have any experience in this yet, but I'll be starting the summer internship at CVS in June and it'll be interesting to see what they say about it.
     
  15. RxWildcat

    RxWildcat Julius Randle BEASTMODE!
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    I just saw a CVS commercial advertising this, they're really pushing it.
     
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  17. Aznfarmerboi

    Aznfarmerboi Senior Member

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    If i get fired, Wags, Rite Aid, etc will hire me and probably pay me more with a new sign on bonus. My point is unless you are stealing, drinking on the job, not filling prescriptions or sexually harrassing somebody, they will not fire you. All the chains come out with new programs to increase their sales but at the end (besides pushing generics) usually fades away. . . because nobody follows it carefully. A large part is because the chains does not provide the pharmacist with the tools to do so (in this case, probably more hours).

    Farmercyst, yes that is OBRA. However OBRA is like JACHO. It doesnt really give anybody a set of rules and tell them to obey it. Rather, it tells each state they must come up with laws and regulations based on a certain thing. That is why I am not sure if it is only for NYS or nationwide.
     
  18. b*rizzle

    b*rizzle Master of Useless Info

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    And don't you still have to get all of your Rxs out in 15 minutes? You can't convince me that their "higher ups" have worked as retail pharmacists for an extended period of time. This is absolutely ludicrous.

    I'm currently doing my community IPPE in an independent pharmacy...**** like this just makes independents look more and more appealing. Thank goodness for co-ops.
     
  19. b*rizzle

    b*rizzle Master of Useless Info

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    Technically, OBRA 90 applies to government-funded insurance. If you want to get reimbursed from Uncle Sam, you'd better make sure you offer to counsel those Medicaid patients. But we apply the rules to everyone because it's easier to do it that way.
     
  20. Lopyswine

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    yes we still get EVERY script done in 15 minutes.

    so right now we are price matching walmart like crazy. doing "PCI" consultations, tons of phone calls, and STILL turning out the scripts.

    Major problem: we are tired. things will begin to get missed... its inevitable. they cant work the entire chain this hard without something bad happening... .just wait and see.
     
  21. Old Timer

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    You have the basic outline of the program correct, but your details are 100% wrong. For those of you who have seen the little video, this is being sold as a way to increase compliance with prescribed therapy. CVS has studies that show 1/3 of all patients who start on a new medication will stop within the first thirty days. This is a chance for CVS pharmacists to intervene at the correct time with the correct patient. You are finally encouraged to do something clinical and your too busy filling scripts to do it????:thumbdown:thumbdown:thumbdown:

    Incorrect. For every new patient you are to offer to transfer any other prescriptions and explain the benefits of having all of your prescriptions filled at one place. This is not to be done for every new prescription. Do you like people who pharmacy hop from place to place? Don't you want to be able to monitor their therapy for drug interactions?

    Again, incorrect. This is only on new prescriptions for a first time fill with a new medication or a new class of drug.

    Again, incorrect. This is the most time consuming part of the process. This is for patients who have refills due in the coming week and also have medications that are past due in being refilled. CVS has found that if you call Mrs. Smith and discuss why she is late filling her diabetes medication, you are basically scolding the patient and the calls are poorly received. If you call Mrs. Smith and say we see your HCTZ and Metoprolol are due to be renewed, would you like us to do it for you? If they say yes, then you say, we also see your over due to get your Glipizide (which is now two weeks past due) and you get a chance to see if the MD stopped it or changed the dose or you have a case of poor compliance which you can impact with these calls.

    This program is clinically driven to increase patient compliance. If we increase patient compliance we will by definition increase volume as the prescriptions that have gone by the wayside will now be filled.

    Are there things about the program I don't like? Yes, It drives volume onto the weekend where staffing is lighter. They are supposed to roll out a national call center where all incoming pharmacy calls will go to a central call center. If you need to speak to the store directly, you will be transfered. This is expected to decrease incoming calls by 85%. This will free up the time to make the outgoing calls. I wish they had rolled out the call center arm first. I also wish they had put on a few extra hours the first couple of weekends to get this started.

    All in all, I made 70 calls last weekend and I can tell you for the most part they were extremely well received by the patients and I was able to discuss the importance of compliance with couple of people who had stopped their medications inappropriately. This is being done as part of the Caremark merger and is being sold to employers as a way to increase compliance and thereby improve outcomes and in the long run decrease health care costs. You have a real opportunity to be clinical pharmacists. Take your spatula's out of your ***** and get to work. It's what you went to school to do.
     
  22. Lopyswine

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    wow talk about propaganda....


    the only way this program will work is if CVS bites the bullet and spends more money on TECHS!!! allow for more techs to be working, this will allow the pharms the time to do all the councils and calls. without more techs, the pharms will find themselves overwhelmed. it will happen. you watch.


    and you stop drinking the koolaide about how this is for the patients. its for the CVS bottom line. period. they need a way to distinguish themselves from the competition and apparently $4 generics isn't in the picture so they decided to overwork their already overworked employees.

    If this program was TRULY for the patients then CVS would SPEND THE MONEY NECESSARY to make it work.
     
  23. Old Timer

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    You post 100% incorrect information and then you accuse me of drinking Kool-aid.

    OK.......
     
  24. MountainPharmD

    MountainPharmD custodiunt illud simplex

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    Exactly. Please don't ever say a chain such as CVS is doing something to benefit the patient. They do it to increase thier bottom line. I do not see how adding more work to already under staffed and over worked pharmacies is ever going benefit anyone.

    Leave it to Old Timer to break out that CVS drum and start beating it no matter what.
     
  25. mike36

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    While I do not believe that CVS is doing this for the patient, it sounds like a great opportunity for retail pharmacists to actually practice what they learned in school versus just dispensing the meds.

    I think that this is a good step for retail to take, however, in order for the pharmacists to have time to perform their clinical duties, there must be the support (i.e. pharm techs) for this to happen.

    Also, the 15 minutes per script is ridiculous. I do not understand how any self-respecting pharmacist that spent all those years in school could sacrifice quality for filling scripts a little faster.

    I probably don't know what I am talking about since I only have about a week of pharmacy experience in an independent pharmacy...
     
  26. BMBiology

    BMBiology temporarily banned~!

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    How is the pharmacist going to perform clinical duties when the pharmacy is understaffed? This seems like a halfass effort. Why doesn't CVS hire some pharmacists to call patients and make sure they are taking their medications as prescribed? I think that's what they should do if they care about their patients. You don't need to be a pharmacist to know that.
     
  27. xxfoolxx

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    oh this will be fun... now we just need walgreen's and rite aid to offer $25 gift cards for transferred prescriptions and we'll have RX's floating back and forth between multiple chains. I can see it now... people will take CVS up on their offer to transfer RXs and then patients will get a gift card to transfer it back to walgreen's or rite aid
     
  28. ethyl

    ethyl Go suck on a Zoloft.
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    Why would CVS start implementing this now when they haven't gotten their new computer program out? I like how Walgreens started with the time saving programs first before implementing the MTM. Any word on if CVS will come out with a "Resolution Center" for all insurance rejects like Walgreens has been testing? Or like the Walgreens program with the central dispensing center that delivers 'completed' scripts to the pharmacies by 3-4pm every day.
     
  29. Farmercyst

    Farmercyst From the shadows
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    While ultimately it may be the almighty dollar directing the decision, I don't see how this could ultimately end up being bad for a patient, at least if it's done as it's intended to be done. It's easy to be cynnical in the corporate world, but even ulterior motives aside, it sounds at least like a worthwhile attempt.
     
  30. MountainPharmD

    MountainPharmD custodiunt illud simplex

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    Sweet I get to quote myself!!!

    This is how it is bad for the patient. If they do not give us enough help and support how can we possilble do anything well?
     
  31. laimyours

    laimyours like my hat?

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    In California all new prescriptions require consultation, you are not suppose to ask. So that's nothing new for Ca and NY. Why doesn't CVS get a automated telephone system? I work for target and the auto refill phone calls go out automatically 2 days after the rx comes out, and 2 days before the rx is to be returned.
    I don't believe you will get fired for not making the silly phone calls. And if your state law doesn't require consultation then you're ok there too. They will lose too many employees and no one will want to work at CVS. Just put on a show when your district manager comes and you'll be fine.
     
  32. Old Timer

    Old Timer SDN Advisor
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    This does NOT replace the regular counseling required by State and Federal laws. It is in addition and it is specific counseling for patients on new therapy.


    CVS does have automated calls for refills that have not been picked up. They call at day three and day seven.

    You will get fired for deliberately disobeying your superiors. If you flagrantly disregard the program or any other legitimate request of your boss. That being said if you attempt to make the calls and do not complete them, you will probably be fine.
     
  33. Old Timer

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    I know you guys like to bash CVS but does truth mean anything to you guys?

    Do you understand the 15 minutes thing is only for people waiting in the store? It does not apply if there are problems. You don't start the clock ticking until after the claim is approved by the insurance. Once you get a paid claim, then you inform the patient it will be 15 minutes or less. If you spend 20 minutes getting diddled on hold by an insurance hep desk, that DOES NOT count in the 15 minutes. If there are many scripts waiting ahead of them, the 15 minute rule does not apply. For all of you who work at a CVS store, please go back to your and print your promised when ready report for the month of April and tell me what your average time to verify a prescription is. I bet it is under ten minutes. So the 15 minute thing is not totally unreasonable. You're doing it anyway. It does not apply to Mrs. Smith who calls in 10 refills on the phone.

    Do you also understand the goal is 95%, not 100%. If you are a little under, you wont have a problem is you are at 50%, you will.

    I personally agree there is not enough tech help to do this program the way CVS wants to and they should have done the Call Center piece first to free up Pharmacy staff. That does not make the idea bad, just the implementation. I also agree that the reduction in tech hours in January was bad. I do not like it and does make it harder on the Pharmacist.

    Also, there is nothing wrong with CVS wanting to make money. That's where thet get the money to pay me. My raises have been excellent since I went with CVS. The better they do, the better I do....
     
  34. Lopyswine

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    at out store filling in 15 minutes isn't even an issue. sometimes we take the script at drive thru and tell them it will be done by the time they circle the building and wait in line again. I really cant understand how Wal-mart CANT turn the scripts around in 15 minutes...

    In CVS "lingo," I can't remember the last time we had a script go RED. It just doesn't happen. If you are good at 3rd party billing, and have 2 techs at production, missing the 15 minutes isn't even a possibility.
     
  35. RxWildcat

    RxWildcat Julius Randle BEASTMODE!
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    Well 15 minutes assuming everything goes without interruption, but more often than not the phone rings every 30 secs and people come up and ask questions ALL day long. Thats the difference.
     
  36. Lopyswine

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    YOU SHOULD STILL BE ABLE TO DO IT IN 15 minutes.

    if you get a paid claim. NO script should take more than 15 minutes. It takes our pharmacists about 2 minutes to check a prescription. You can find 2 minutes.
     
  37. RxWildcat

    RxWildcat Julius Randle BEASTMODE!
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    My pharmacy isn't located in Fantasy Land, so that isn't really the case.
     
  38. bananaface

    bananaface Pharmacy Supernerd
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    But what if there are 8 prescriptions. :p
     
  39. PharmDstudent

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    -->
     
  40. RxWildcat

    RxWildcat Julius Randle BEASTMODE!
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    15 [email protected]!

    :laugh:
     
  41. bananaface

    bananaface Pharmacy Supernerd
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    Yeah, I'm confused about the OPs position on this one. At first the thread was all about how CVS doesn't provide their stores the resources for a fill in 15, then we were at everyone can find 2 of 15 minutes. I heard something about already overworked employees and something about how your prescription is ready before you set it down on the counter. I want some Kool-Aid.
     
  42. Lopyswine

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    say what you guys want. you got the gist of my points about the speed of script filling.

    If you guys can't fill scripts that fast than you will be eaten alive in retail pharmacy if you decide to go that path. The computers record out speed at filling and answering the phone. Every single customer has the option to call in and rate us... some even get codes to type in and the scores they give us count towards pharmacists record... you guys better find the speed.

    As for the propaganda comment. I was trying to say that the whole PCI program is propaganda to bring in more business, but all it will do is slow the pharmacy down and lead to upset customers....
     
  43. PharmDstudent

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    If it's 5 scripts --> 30-45 minutes. If it's 6-10 scripts --> 45 minutes-1 hour. If it's more than 10 scripts --> 1 hour.
     
  44. PharmDstudent

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    There is no need for the lecture. I've worked for CVS before, twice actually.
     
  45. Lopyswine

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    no no no. I guess I wasn't being clear, I rarely am...

    What I am trying to say is that currently we have no problem pumping them out in 15 minutes for any customer with about 1-5 scripts. However, with the new PCI program in place, it is becoming much harder to do, this will lead to over working, fatigue, upset customers, and eventually MISTAKES.

    Also, considering the fact that walmart is doing the $4 generics WITHOUT a 3rd party, I really cant see why they fill so slow...
     
  46. Lopyswine

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    what pharmacy uses that scale?
     
  47. PharmDstudent

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    This is what it's like working at CVS:
    [YOUTUBE]http://www.youtube.com/watch?v=V-Po8uJeoUw[/YOUTUBE]
     
  48. Lopyswine

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    Oh btw,

    Here's a little PCI story from today that I would like to share. So today was my first saturday since PCI started. On saturdays the pharmacy gods produce a list of refill calls we have to make. Our list today was over 10 pages long.

    So we have 3 techs and a pharmacist making calls. We start at 10am. From 10am to about 1030am we're doing ok... then everyone in town wakes up and the day begins....

    Its very difficult to get the calls done by noon when there is a line at drive thru and at the register. Somehow we manage to get the calls done. The calls are not finished until 2pm. So it took 4 hours to do something that was supposed to take 1-2. During that time I was yelled at by 3 different patients. "I can manage my medicine." "Please dont ever call me at home on a saturday again." "Hang on a second, you're calling me trying to tell me about medicine I may need filled?"

    and my personal favorite:

    "Hi I am @@@@ from CVS yada yada yada, is XXXXX there?"

    "XXXXX passed away last night."


    WOW good job CVS. They didn't put a sample conversation in the training manual to deal with a weeping daughter who wants to know why we are calling asking to fill medicine for her deceased mother.....

    fun times.
     
  49. PharmDstudent

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    Ok. We understand what you're saying. Thank you for clearing that up.
    They have way too many scripts to fill.
     
  50. Lopyswine

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    I worked in walmart for a few days. They dont do much more volume than we do. We fill 400-700 scripts a day. They about the same without nearly as much insurance issues.... I guess it comes down to the fact that walmart customers are probably just more difficult to deal with.
     
  51. PharmDstudent

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    That's my honest and best gestimate for new scripts. I've been doing the retail gig long enough to know how long, in general, it usually takes for someone's scripts to be filled. Also, it's safe to say that 1 out of 5 or 1 out of 7 scripts will be problematic.
     
  52. PharmDY

    PharmDY Reach for the Stars

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    lucky u to have 3 people on Saturday. at the pharmacy i work at, there is only me and the pharmacist every saturday. to top it off, i'm not even a licensed tech! i'm paid a clerk to do a tech's job (everything but filling--yea i do TARs).. we really need a union..:confused:
     

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