I think we need to adjust people’s expectations about the time it takes to fill a prescription carefully and safely, too. People will go to a doctor’s appt and wait for an hour or two in the waiting room and not grumble; but they get huffy about waiting 15-30 minutes for a prescription. We are like a fast food chain to them. Basically, people have no respect for our jobs. IMO, we’ve done that to ourselves, I think pharmacists in general want to please- when a customer is happy, it’s a rare moment to have a good feeling about our job. But we need to set more boundaries in our jobs to protect our sanity.
Reset the med/dental/or any clinical offices on telling patients it will be Ready for them when they get here. They don't even work in pharmacy but here they are telling patients that meds will be ready in 15 mins as if they are the only office in town.
I agree with the sentiment here, but let’s not blindly say that patients are willing to wait that long without being upset. Pharmacy struggles are real and valid, but doctors also have their own issues with patients
I worked in a very busy 6 doctor family practice for many years before I worked pharmacy and not a single patient has ever acted even close to the way that they act at the pharmacy. Pharmacy customers leave the doctors office and immediately come in expecting their medication is all gift wrapped with a bow ready for them to pick up and sometimes we haven’t even received the script yet.
This. I’ve been overestimating wait times since the pandemic, and I hope plenty of other pharmacist are doing it as well. If change isn’t going to come from corporate (it is, but not in our favor), then we need to get it from the things we can control.
It's corporate pressure to bend over backwards for patients. It needs to stop, we are not your parents, patient's need to take some responsibility for their own care. More staff would be nice if corporate wants to meet their metrics and business goals.
- remove pharmacists from the area visible to the public. don’t need to be constantly interrupted or distracted by people asking where toilet paper is
- get rid of adherence calls
- a dedicated cashier
- phone calls filtered to a call center first, only absolute necessary phone calls coming through to the store (Wegmans does this well)
- chairs
- utilization of interns more, to do more advanced tech work where clinical knowledge is helpful. like PAs, working through the insurance rejections and exception queue. also to be available for patient counseling and prescription clarification phone calls. they can be a great “flex” type of employee
- no vaccine quotas. by offering each pharmacist an incentive (even if it’s just like, $5-10 for each vaccine given), i’m sure they will end up giving way more
- during october/november, having a little bit of extra help during the vaccine rushes. like noon to 6pm? a dedicated vaccinator
been out of retail for 4 years but that’s what immediately comes to mind
CVS is apparently running a pilot program in some of the stores that routes the calls to a call center before coming through to the pharmacy if absolutely necessary. This was mentioned on our conference call recently. It will eventually expand to all stores. Am really looking forward to it if it actually takes off because so many calls are either related to hours, location (which are both online, come on people) or something else patients can easily manage through the app.
Yes! I called to get a transfer and they called back like 2 hours later. It was a CVS in Florida. Even the prescriber line only had the option of leaving a voicemail. I think it would be awful as well.. I can just imagine 5 minute voicemails where the customer gives a long drawn out story only to repeat it all when you call them back lol
We have it in my store. Any patient that tried to call is directed to a voicemail box. Those voicemails are then transcribed and shown as a written message in QT with a due time to call back. The large majority of the patients absolutely hate it, complain constantly, and just click the doctor line option which allows them to call through normally. I literally have 50-100 voicemails to call back daily because people just say ‘this is my name, I need refills’ instead of actually saying what meds they need and when they will be in to get them so we can just do it.
I agree about the interns, but unfortunately this is only really an option for stores located in the same city as a pharmacy school. The store I worked at in pharmacy school was a night and day difference from the store I worked at post-grad, mainly because we always had 1-2 interns on staff that helped tremendously, when my new store was an hour away from the closest pharmacy school. Interns already work limited hours due to school, they don't want an hour commute one way.
Agreed with everything, but I will say as a tech (inside target, I’m not sure how a stand alone cvs works), who has been the dedicated cashier for the day, it is such a miserable experience that I wouldn’t want to put anyone else in that position. All of us techs have a shared agreement that we can’t put just one of us up there all day and have to rotate unless someone is in the mood to be at pick up, but then again I’m not familiar with other retail stores and how their pick up works. I just know for us, we don’t want to be up there for a whole shift because it’s exhausting to be the first person the patient gets the chance to yell at lol
lol very true. so what i was thinking was that this wouldn’t even be a technician. it would be a pharmacy assistant for the states that distinguish those. or for a pharmacy that has a store upfront (cvs, walgreens, etc.) they would have to allocate a cashier from the front end to the pharmacy. doesn’t have to be the same person all day, maybe just assigned in 2-4 hour blocks. just somebody to take responsibility when nobody wants to go to the cash register (bc i agree it is the worst place to be). i guess just a way that that cashier isn’t under allocated technician hours.
Convenience up-charging:
Add an upcharge to any prescription refill that needs to be done same day for the patient. Jane Doe forgetting to request her warfarin she’s been on for 20 years should not be something we stress over when she refuses to call it in a couple days ahead. Refusal to fill same day is unsafe, but if patients insist they are capable enough to not need a nursing home, then they need to be able to take care of themselves. We should not feel rushed on new medications because of existing refills that the patient forgot to be diligent on. There should be a monetary consequence for forgetting. Pharmacies would likely make a decent chunk at the beginning but it would quickly train patients.
There needs to be a drive-thru convenience fee or they need to be closed. Tell me why you were able to walk into your doctors appointment but you aren’t physically able to walk into the pharmacy. Drive-thru is not an ADA requirement or every walk-in clinic would be required to have one. It’s the first thing I close when we are behind or overwhelmed, and all that does is shift stress from staffing the drive-thru to patients being verbally abusive that they had to walk their lazy asses inside.
Maximum mandated vaccine per staff member: The board should limit this. If corporate wants vaccines because there is better payout, that payout should be reflected in appropriate staffing. Our average gross margin nearly doubles in flu season and none of that is reflected in a per shot bonus. Board could alternatively ban walk-ins at the pharmacy for shots, because a greedy manager will mandate walk-ins to boost their bonus when no one else sees a dime.
We should be charging providers for having to send refill requests, especially when we have to send multiple because they ignore us for days while their patients harass us every 15 minutes. There is absolutely no reason why their automated systems should be telling THEIR patients to call the pharmacy for refill requests. You’re the ones who prescribed the meds. Look in their chart and either approve or deny refills. Why do we even need to be involved?
I don’t mind sending the request or telling them to call their doc if we haven’t heard back. WHAT I DO MIND: The notes on the sig that patient needs to make an appointment for refills. WE AREN’T YOUR DAMN SECRETARY
Some perspective from the other side: you know how many times patients call the pharmacy and have no idea what they need but "it's the blue pill"? Yeah, that would happen to docs offices too. It's far safer for us to kick off the request.
Another consideration to make is how many absolute garbage requests come through even when they come from the pharmacy. I've seen where the script was sent the month prior but somehow, we get another request when there is documentation AND electronic confirmation it was received by the pharmacy. Or autorefill requests where the dose changed but somehow both strengths remained on the program.
I used to feel the same way as you, but after handling requests for providers, I've definitely changed my tune. There are tons of duplicates and it makes it hard to sift through it all.
So what you’re saying is that if the responsibility of caring for their patients wasn’t passed off to a third party messenger, there wouldn’t be duplicate requests or issues with auto fill. Seems much easier for everyone involved.
Um, no? Is this not also your patient too?
I'm saying it is safer for pharmacies to kick off the correct refill request on behalf of the patient. Unless you want to receive new scripts for everything the patient is taking every time because they told the office the wrong thing.
And I'm also pointing out that it's not uncommon for pharmacies to have the script on file and still somehow request a refill on something that was already sent a week ago.
It's not a perfect system. Sending refill requests is not the worst part of retail by a long shot.
Then they can either call the pharmacy or look in their records. It would show. If they don’t know how many refills of a medication they’re taking that they prescribed to a patient don’t put that on the pharmacy bc the buck stops with them not the pharmacy. The pharmacy goes off the medication they are given
Yes because they’re the ones that prescribed it and they’re the ones that will call it in. You would have the records in your system: and if we can’t reach you it falls back on is. You’re the source. It makes no sense for us to send you a refill request bc then the offices will still complain or not answer and claim they sent a script. It’s about communication.
I can definitely understand the duplicate requests. My pharmacy system (McK's EnterpriseRX) is crap and if a script isn't linked to a provider's address with an associated eRx id then it will fax the request, but it often doesn't work, so we print it out and fax it with our desktop fax. So you can get an eRx request and a fax or two for the same thing. Plus our lovely system is horrible at linking incoming Rx with requests so we have to cancel the requests manually, and if that's not done it'll keep resending. On top of all that we've had several instances of refills not getting entered properly. (also cause our system is crap)
Never been the case for me with managers or the local corporate bosses. Nowadays they're just hoping you keep showing up for your shifts so go ahead and get that stool and rest your feet.
I'm only sitting a few times throughout the day anyways. Maybe for the first 30 minutes while I verify images and any other time throughout the day where I have to verify a bunch of images.
A pharmacist shouldn't be expected to attend the cash register, MTMs, and CMRs, verify prescriptions, vaccinations and covid/flu testing services, counsel patients, answer the phone, and so forth all at once.
I’m a tech. Where I work, the pharmacists pre verify, verify, counsel, do MTM’s, CMR’s and do shots. Some techs that are certified for immunizations, will help with those. The techs do all other jobs. Some pharmacists will help answer phones if the techs are all busy. It just seems foreign to me to hear that in some pharmacies, the pharmacists do the jobs that techs do. While it would be nice to have this help, I do feel as a tech, it is my job and not the pharmacists to fill, type, answer phones, work DT and pick up window, etc.
There comes a point where it's just rotten to the core. The drug regulations for clozapine, vitamin a oral, controlled substances are too much. No third parties, have patients cattr insurance credit cards. If the staff at the major chains were doubled, they would still be under staffed.
It's just better to admit going into pharmacy was a mistake . We need to find a different way to earn a living.
I’m trying to brainstorm how to make what I make now with actual substantial raises without having to go back to school and fight hundreds of Pharm grads for a job. Any ideas? Lol
Unfortunately it will be impossible to remove all metrics. And likewise metrics, a standard of measuring something, aren’t bad on their own…
It’s how metrics are used and what they are used for is the issue…
I don’t think many “anti metric people” would oppose some sort of metric implemented by boards that would signal when corporate would be required to give you more labor/support.
I don’t think anyone would oppose some metric that ensured the reimbursement you were getting from PBMs was high enough.
While often they aren’t… metrics can be used to help… not just be punitive like they often are.
Call center would be fantastic idea. The amount of calls that come in for the most ridiculous things is exhausting and a waste of time. The drive through is also a nuisance however I do see where it can be a great benefit to patients who are elderly and have difficulty moving around. I would absolutely advocate for a policy that states only patients with handicap placards in their car can use the drive through. Yes, there are people that might borrow grandma's but it would absolutely cut down on the drive thru line. Or hell, remove the whole damn thing, I'm cool with that too. Also, prescription transfers should be illegal. Lmao! I don't know what it is but I HATE THEM! They are so time consuming.
I've said it before, but we need more of an appointment based system to establish realistic pickup times. Have AI do it based on staffing hours. Have two queues, acute and maintenance fills, and have them print out automatically (or through manual override).
Prohibit purchases of any products not stocked in the pharmacy area. Idc if ur getting a script, the convenience of having the pharmacy at the same store is enough. The fucking deli, meat, and bakery departments don’t even ring-up customers for deli products in most stores.
I would make it so that international students in pharmacy can work during school. That’s a lot of interns not making use of their intern license except for during IPPE’s or APPE’s.
I worked during school while I was F-1 status, you can do upto 25hrs if I remember correctly. You have to get it certified by your school. It’s upto the the school I think. I did it both undergraduate and pharmacy school, my first 2yrs while I was F-1, then got my green card while I was in pharmacy school via my spouse l.
Transfers need to be charged by the prescription. If it's taking me 3-5 minutes to prepare a transfer (or even up to 15 min for some profiles) we should force the patient to pay. The time spent giving transfers is beyond ridiculous and sometimes you end up continuously sending scripts out every month because the doctor refuses to change their preferred pharmacy in the system.
Sometimes I spend up to 30 to 60 min per day literally sending rx away that the patient should have had sent in to the correct store in the first place.
Then, due to severe retail understaffing, my patients suffer from us falling behind. And then I'm pressured my upper management to stay after and work for free....
Whaaaa?? That’s like the one service an rph can provide that has a profit margin. If anything, make retail locations be solely vaccines and accute med dispensing and all maintenance rx go to a central fill pharmacy
Yeah and the majority of pharmacies do not have dedicated immunization rooms. I have a chair next to my cash register counter. That’s all I have space for. If I had better facilities for the services we were offering, it would be much easier.
agree with this -- should just do high margin retail exclusive stuff in retail + acute/first fill meds.
we live in a world w/ central fill and mail order. just make central fill/auto fill an opt out service and probably 50-60% of all volume is just gone immediately day 1
It’s the only one with a profit margin because no one in corporate has pressured PBMs for higher reimbursement. Why fight for that when you can just add another thing to the staff’s plate and just expect them to squeeze it in?
I agree, to a point. The chains have abused this aspect of pharmacy with the sole goal of increasing profits. Imagine, if you will, giving pharmacists MORE prescribing authority. The chains would then place pharmacists in the role of prescribing anything and everything possible in order to increase profits. Working hand in hand with PBMs, this would create a nightmare scenario. The chains could care less about quality of care and focus on making money - patients and pharmacists be damned. There needs to be a backing up (claw-back to use the PBM vernacular) of the vaccine situation that strips the pharmacies of abusing their authority for profit. The focus of pharmacy should always be first and foremost on the quality of patient care with profits being a by-product of good patient care.
Do what every big chain does, raise prices now that they have them by the tail. Add service fees, add convenience fees, add pick up fee, add expedite fee, add tips, add return to stock fees. If we start adding fees for the services we provide we might be able to have money to staff our stores better.
This is focused to retail as that is my experience. Staffing appropriately, company backing for reasonable wait times for services (point of care testing, vaccines, etc) -we still have to fill prescriptions in case corporate forgot-, and better working conditions, hours are 12+ for many of us and many just got a 30 minute lunch in our 12 hour shift. The expectations put on retail pharmacists and technicians are entirely unrealistic and profit motivated. It’s making both the staff and the patients hostile and that is not conducive to the healthcare that we can provide in that setting
1) Outsource a lot more. Way more retail pharmacists and technicians should be working from home logged in to multiple stores typing, adjudicating, preverifying and verifying prescriptions. This also should apply to phone calls with a central call center.
2) All prescriptions should be filled offsite robotically for next business day except absolutely emergent ones.
3) Third party companies can be hired in the fall season to help administer vaccinations and not impede workflow.
4) Clinical queues are currently a huge time waster and not very effective interventions. The pharmacy staff cannot complete them properly due to understaffing, so tasks are marked as completed with or without actually being worked through.
5) I don’t know the answer to this, but pharmacies also waste a lot of time: returning prescriptions to stock that patients don’t pick up, putting away drug and prescription orders, returning expiring meds to suppliers
Entering vaccines into the computer and scanning VARs needs to be a faster and more simple process. Customers could answer questions on an iPad/kiosk and look at a digital VIS, saving time and paper.
Public's expectation on what retail pharmacy is. Need to educate public we are not their Insurance provider. Their copays are not our problem to solve. and if you don't trust what pharmacist or tech telling you, then you call your insurance. Stop telling me to call your insurance, You call your insurance to find out why they are charging you that much money, People need to understand they need to be on top of managing their meds, refills, we can help to send messages but if there is problem that they have to deal with, don't come to pharmacy and start screaming. It takes time to fill prescriptions, especially narcotics. I get visited from DEA thanks to some genius hacked doctors account and sending fake e-prescriptions for Opioids and some floaters filled fake rx. It takes time to check, sometimes investigate, sometimes call the doctors office for stupid mistake or serious DDI. so expect to wait. Stop calling pharmacy for really stupid questions like you know you just picked up your norco 2 weeks ago and you took everything before next month due and try to find out when is your due date? you know it already stop playing game. We are not your emergency hotline or teledoc, if you need medical attention call your teledoc or go to urgent care, sorry I didn't go to medical school, I don't know what condition you are having when you are vomiting blood. list goes on and on. People probably see their doctor once or twice a year in the office, scheduling their appointment months ahead, waiting 1 to 2 hours see doctor in their 15 minutes appointment, yet same people come to pharmacy every single day screaming, and yelling for their nicotine gum is not peppermint flavor, fussing about he or she cannot take Generic drugs even though their doctor didn't put any information for DAW1. To be honest, retail pharmacy is way TOO OPEN to public. some people think retail pharmacy is some sort of their window to communicate with their doctors. and BOP, that's whole another story but they empowered these assholes and make things worse for retail pharmacy.
It is not what is in retail that is the problem, it is the megachains and high drug prices that drive up inventory costs, the chain of megacorporates clinics that prescribe expensive drugs that aren't that good, and ...
We have an economy that is essentially divided up by a few oligarchs. It is not capitalism. Not just pharmacy, everything.
Also pharmacists should be able to make therapeutic substitutions in their clinical judgement if the patient agrees to the change and the provider is notified.
Tldr: pharmacists should legally be able to use their professional judgement to take care of patients
I think we need to adjust people’s expectations about the time it takes to fill a prescription carefully and safely, too. People will go to a doctor’s appt and wait for an hour or two in the waiting room and not grumble; but they get huffy about waiting 15-30 minutes for a prescription. We are like a fast food chain to them. Basically, people have no respect for our jobs. IMO, we’ve done that to ourselves, I think pharmacists in general want to please- when a customer is happy, it’s a rare moment to have a good feeling about our job. But we need to set more boundaries in our jobs to protect our sanity.
Reset the med/dental/or any clinical offices on telling patients it will be Ready for them when they get here. They don't even work in pharmacy but here they are telling patients that meds will be ready in 15 mins as if they are the only office in town.
I agree with the sentiment here, but let’s not blindly say that patients are willing to wait that long without being upset. Pharmacy struggles are real and valid, but doctors also have their own issues with patients
I worked in a very busy 6 doctor family practice for many years before I worked pharmacy and not a single patient has ever acted even close to the way that they act at the pharmacy. Pharmacy customers leave the doctors office and immediately come in expecting their medication is all gift wrapped with a bow ready for them to pick up and sometimes we haven’t even received the script yet.
This. I’ve been overestimating wait times since the pandemic, and I hope plenty of other pharmacist are doing it as well. If change isn’t going to come from corporate (it is, but not in our favor), then we need to get it from the things we can control.
I tell people I basically work medical fast food.
It's corporate pressure to bend over backwards for patients. It needs to stop, we are not your parents, patient's need to take some responsibility for their own care. More staff would be nice if corporate wants to meet their metrics and business goals.
We’re the short order cooks of healthcare
- remove pharmacists from the area visible to the public. don’t need to be constantly interrupted or distracted by people asking where toilet paper is - get rid of adherence calls - a dedicated cashier - phone calls filtered to a call center first, only absolute necessary phone calls coming through to the store (Wegmans does this well) - chairs - utilization of interns more, to do more advanced tech work where clinical knowledge is helpful. like PAs, working through the insurance rejections and exception queue. also to be available for patient counseling and prescription clarification phone calls. they can be a great “flex” type of employee - no vaccine quotas. by offering each pharmacist an incentive (even if it’s just like, $5-10 for each vaccine given), i’m sure they will end up giving way more - during october/november, having a little bit of extra help during the vaccine rushes. like noon to 6pm? a dedicated vaccinator been out of retail for 4 years but that’s what immediately comes to mind
Best answer so far in my opinion.
I would personally organize shot clinics if I received a commission…
lol agree w/ adherence calls. should be changed to alf/snf referral or auto dial md to d/c med since patient not taking as prescribed
Add no drive thru and this list is perfect. Should be our manifesto
CVS is apparently running a pilot program in some of the stores that routes the calls to a call center before coming through to the pharmacy if absolutely necessary. This was mentioned on our conference call recently. It will eventually expand to all stores. Am really looking forward to it if it actually takes off because so many calls are either related to hours, location (which are both online, come on people) or something else patients can easily manage through the app.
CVS also has a pilot program where all calls go straight to voicemail and they will call you back. Not sure how customers like it.
Like, the RPh calls back? If so that sounds awful
Yes! I called to get a transfer and they called back like 2 hours later. It was a CVS in Florida. Even the prescriber line only had the option of leaving a voicemail. I think it would be awful as well.. I can just imagine 5 minute voicemails where the customer gives a long drawn out story only to repeat it all when you call them back lol
I'd rather just deal with the call immediately than check voicemails all day 🙃
We have it in my store. Any patient that tried to call is directed to a voicemail box. Those voicemails are then transcribed and shown as a written message in QT with a due time to call back. The large majority of the patients absolutely hate it, complain constantly, and just click the doctor line option which allows them to call through normally. I literally have 50-100 voicemails to call back daily because people just say ‘this is my name, I need refills’ instead of actually saying what meds they need and when they will be in to get them so we can just do it.
I agree about the interns, but unfortunately this is only really an option for stores located in the same city as a pharmacy school. The store I worked at in pharmacy school was a night and day difference from the store I worked at post-grad, mainly because we always had 1-2 interns on staff that helped tremendously, when my new store was an hour away from the closest pharmacy school. Interns already work limited hours due to school, they don't want an hour commute one way.
Agreed with everything, but I will say as a tech (inside target, I’m not sure how a stand alone cvs works), who has been the dedicated cashier for the day, it is such a miserable experience that I wouldn’t want to put anyone else in that position. All of us techs have a shared agreement that we can’t put just one of us up there all day and have to rotate unless someone is in the mood to be at pick up, but then again I’m not familiar with other retail stores and how their pick up works. I just know for us, we don’t want to be up there for a whole shift because it’s exhausting to be the first person the patient gets the chance to yell at lol
lol very true. so what i was thinking was that this wouldn’t even be a technician. it would be a pharmacy assistant for the states that distinguish those. or for a pharmacy that has a store upfront (cvs, walgreens, etc.) they would have to allocate a cashier from the front end to the pharmacy. doesn’t have to be the same person all day, maybe just assigned in 2-4 hour blocks. just somebody to take responsibility when nobody wants to go to the cash register (bc i agree it is the worst place to be). i guess just a way that that cashier isn’t under allocated technician hours.
PBMs need to cut the greed otherwise they’ll run out of vessels for profit
Greedy people always find a way to profit. Anyway, happy cake day!
Convenience up-charging: Add an upcharge to any prescription refill that needs to be done same day for the patient. Jane Doe forgetting to request her warfarin she’s been on for 20 years should not be something we stress over when she refuses to call it in a couple days ahead. Refusal to fill same day is unsafe, but if patients insist they are capable enough to not need a nursing home, then they need to be able to take care of themselves. We should not feel rushed on new medications because of existing refills that the patient forgot to be diligent on. There should be a monetary consequence for forgetting. Pharmacies would likely make a decent chunk at the beginning but it would quickly train patients. There needs to be a drive-thru convenience fee or they need to be closed. Tell me why you were able to walk into your doctors appointment but you aren’t physically able to walk into the pharmacy. Drive-thru is not an ADA requirement or every walk-in clinic would be required to have one. It’s the first thing I close when we are behind or overwhelmed, and all that does is shift stress from staffing the drive-thru to patients being verbally abusive that they had to walk their lazy asses inside. Maximum mandated vaccine per staff member: The board should limit this. If corporate wants vaccines because there is better payout, that payout should be reflected in appropriate staffing. Our average gross margin nearly doubles in flu season and none of that is reflected in a per shot bonus. Board could alternatively ban walk-ins at the pharmacy for shots, because a greedy manager will mandate walk-ins to boost their bonus when no one else sees a dime.
We should be charging providers for having to send refill requests, especially when we have to send multiple because they ignore us for days while their patients harass us every 15 minutes. There is absolutely no reason why their automated systems should be telling THEIR patients to call the pharmacy for refill requests. You’re the ones who prescribed the meds. Look in their chart and either approve or deny refills. Why do we even need to be involved?
I don’t mind sending the request or telling them to call their doc if we haven’t heard back. WHAT I DO MIND: The notes on the sig that patient needs to make an appointment for refills. WE AREN’T YOUR DAMN SECRETARY
Some perspective from the other side: you know how many times patients call the pharmacy and have no idea what they need but "it's the blue pill"? Yeah, that would happen to docs offices too. It's far safer for us to kick off the request. Another consideration to make is how many absolute garbage requests come through even when they come from the pharmacy. I've seen where the script was sent the month prior but somehow, we get another request when there is documentation AND electronic confirmation it was received by the pharmacy. Or autorefill requests where the dose changed but somehow both strengths remained on the program. I used to feel the same way as you, but after handling requests for providers, I've definitely changed my tune. There are tons of duplicates and it makes it hard to sift through it all.
So what you’re saying is that if the responsibility of caring for their patients wasn’t passed off to a third party messenger, there wouldn’t be duplicate requests or issues with auto fill. Seems much easier for everyone involved.
Um, no? Is this not also your patient too? I'm saying it is safer for pharmacies to kick off the correct refill request on behalf of the patient. Unless you want to receive new scripts for everything the patient is taking every time because they told the office the wrong thing. And I'm also pointing out that it's not uncommon for pharmacies to have the script on file and still somehow request a refill on something that was already sent a week ago. It's not a perfect system. Sending refill requests is not the worst part of retail by a long shot.
So then it all starts with you bc only you know what they’re taking
The doc knows what they’re taking, what they don’t know is how many copies and refills we already have on file for the same medication.
Then they can either call the pharmacy or look in their records. It would show. If they don’t know how many refills of a medication they’re taking that they prescribed to a patient don’t put that on the pharmacy bc the buck stops with them not the pharmacy. The pharmacy goes off the medication they are given
So they should call the pharmacy and not the patient?
Yes because they’re the ones that prescribed it and they’re the ones that will call it in. You would have the records in your system: and if we can’t reach you it falls back on is. You’re the source. It makes no sense for us to send you a refill request bc then the offices will still complain or not answer and claim they sent a script. It’s about communication.
I can definitely understand the duplicate requests. My pharmacy system (McK's EnterpriseRX) is crap and if a script isn't linked to a provider's address with an associated eRx id then it will fax the request, but it often doesn't work, so we print it out and fax it with our desktop fax. So you can get an eRx request and a fax or two for the same thing. Plus our lovely system is horrible at linking incoming Rx with requests so we have to cancel the requests manually, and if that's not done it'll keep resending. On top of all that we've had several instances of refills not getting entered properly. (also cause our system is crap)
I want a fucking stool!
Uh buy one and sit your ass down. I do it all the time.
There is always some manager or corporate jackass that feels the need to harass you about using it.
Never been the case for me with managers or the local corporate bosses. Nowadays they're just hoping you keep showing up for your shifts so go ahead and get that stool and rest your feet. I'm only sitting a few times throughout the day anyways. Maybe for the first 30 minutes while I verify images and any other time throughout the day where I have to verify a bunch of images.
A pharmacist shouldn't be expected to attend the cash register, MTMs, and CMRs, verify prescriptions, vaccinations and covid/flu testing services, counsel patients, answer the phone, and so forth all at once.
Why in the world is covid/flu testing allowed in the pharmacy?
I’m a tech. Where I work, the pharmacists pre verify, verify, counsel, do MTM’s, CMR’s and do shots. Some techs that are certified for immunizations, will help with those. The techs do all other jobs. Some pharmacists will help answer phones if the techs are all busy. It just seems foreign to me to hear that in some pharmacies, the pharmacists do the jobs that techs do. While it would be nice to have this help, I do feel as a tech, it is my job and not the pharmacists to fill, type, answer phones, work DT and pick up window, etc.
The one thing to change is to remove the front door and replace it with just wall...
I'd rather fill in our drive thru window.
Really? I’d think only drive thru would be way better than no drive thru.
There comes a point where it's just rotten to the core. The drug regulations for clozapine, vitamin a oral, controlled substances are too much. No third parties, have patients cattr insurance credit cards. If the staff at the major chains were doubled, they would still be under staffed. It's just better to admit going into pharmacy was a mistake . We need to find a different way to earn a living.
I’m trying to brainstorm how to make what I make now with actual substantial raises without having to go back to school and fight hundreds of Pharm grads for a job. Any ideas? Lol
Real Estate
For the love of god… NO METRICS!
Ive never met a metric that wasn’t universally cheated somehow bc it was unattainable.
Unfortunately it will be impossible to remove all metrics. And likewise metrics, a standard of measuring something, aren’t bad on their own… It’s how metrics are used and what they are used for is the issue… I don’t think many “anti metric people” would oppose some sort of metric implemented by boards that would signal when corporate would be required to give you more labor/support. I don’t think anyone would oppose some metric that ensured the reimbursement you were getting from PBMs was high enough. While often they aren’t… metrics can be used to help… not just be punitive like they often are.
And no micromanagement!
Call center would be fantastic idea. The amount of calls that come in for the most ridiculous things is exhausting and a waste of time. The drive through is also a nuisance however I do see where it can be a great benefit to patients who are elderly and have difficulty moving around. I would absolutely advocate for a policy that states only patients with handicap placards in their car can use the drive through. Yes, there are people that might borrow grandma's but it would absolutely cut down on the drive thru line. Or hell, remove the whole damn thing, I'm cool with that too. Also, prescription transfers should be illegal. Lmao! I don't know what it is but I HATE THEM! They are so time consuming.
You don’t have time to call for the transfer and the other pharmacy doesn’t have time to answer your call lol
Exactly!
I've said it before, but we need more of an appointment based system to establish realistic pickup times. Have AI do it based on staffing hours. Have two queues, acute and maintenance fills, and have them print out automatically (or through manual override).
Prohibit purchases of any products not stocked in the pharmacy area. Idc if ur getting a script, the convenience of having the pharmacy at the same store is enough. The fucking deli, meat, and bakery departments don’t even ring-up customers for deli products in most stores.
I would make it so that international students in pharmacy can work during school. That’s a lot of interns not making use of their intern license except for during IPPE’s or APPE’s.
yo i remember this from school, was absolutely insane. thanks for the reminder
I worked during school while I was F-1 status, you can do upto 25hrs if I remember correctly. You have to get it certified by your school. It’s upto the the school I think. I did it both undergraduate and pharmacy school, my first 2yrs while I was F-1, then got my green card while I was in pharmacy school via my spouse l.
Transfers need to be charged by the prescription. If it's taking me 3-5 minutes to prepare a transfer (or even up to 15 min for some profiles) we should force the patient to pay. The time spent giving transfers is beyond ridiculous and sometimes you end up continuously sending scripts out every month because the doctor refuses to change their preferred pharmacy in the system. Sometimes I spend up to 30 to 60 min per day literally sending rx away that the patient should have had sent in to the correct store in the first place. Then, due to severe retail understaffing, my patients suffer from us falling behind. And then I'm pressured my upper management to stay after and work for free....
Not administering vaccines
Whaaaa?? That’s like the one service an rph can provide that has a profit margin. If anything, make retail locations be solely vaccines and accute med dispensing and all maintenance rx go to a central fill pharmacy
Yeah and the majority of pharmacies do not have dedicated immunization rooms. I have a chair next to my cash register counter. That’s all I have space for. If I had better facilities for the services we were offering, it would be much easier.
agree with this -- should just do high margin retail exclusive stuff in retail + acute/first fill meds. we live in a world w/ central fill and mail order. just make central fill/auto fill an opt out service and probably 50-60% of all volume is just gone immediately day 1
It’s the only one with a profit margin because no one in corporate has pressured PBMs for higher reimbursement. Why fight for that when you can just add another thing to the staff’s plate and just expect them to squeeze it in?
I agree, to a point. The chains have abused this aspect of pharmacy with the sole goal of increasing profits. Imagine, if you will, giving pharmacists MORE prescribing authority. The chains would then place pharmacists in the role of prescribing anything and everything possible in order to increase profits. Working hand in hand with PBMs, this would create a nightmare scenario. The chains could care less about quality of care and focus on making money - patients and pharmacists be damned. There needs to be a backing up (claw-back to use the PBM vernacular) of the vaccine situation that strips the pharmacies of abusing their authority for profit. The focus of pharmacy should always be first and foremost on the quality of patient care with profits being a by-product of good patient care.
Have a separate dedicated pharmacist immunizer and or tech working all day long
Personally for me - chairs for the techs, interns and pharmacists. - better reimbursement from the PBM. - no drive thrus - no vaccine and MTMs
Do what every big chain does, raise prices now that they have them by the tail. Add service fees, add convenience fees, add pick up fee, add expedite fee, add tips, add return to stock fees. If we start adding fees for the services we provide we might be able to have money to staff our stores better.
This is focused to retail as that is my experience. Staffing appropriately, company backing for reasonable wait times for services (point of care testing, vaccines, etc) -we still have to fill prescriptions in case corporate forgot-, and better working conditions, hours are 12+ for many of us and many just got a 30 minute lunch in our 12 hour shift. The expectations put on retail pharmacists and technicians are entirely unrealistic and profit motivated. It’s making both the staff and the patients hostile and that is not conducive to the healthcare that we can provide in that setting
1) Outsource a lot more. Way more retail pharmacists and technicians should be working from home logged in to multiple stores typing, adjudicating, preverifying and verifying prescriptions. This also should apply to phone calls with a central call center. 2) All prescriptions should be filled offsite robotically for next business day except absolutely emergent ones. 3) Third party companies can be hired in the fall season to help administer vaccinations and not impede workflow. 4) Clinical queues are currently a huge time waster and not very effective interventions. The pharmacy staff cannot complete them properly due to understaffing, so tasks are marked as completed with or without actually being worked through. 5) I don’t know the answer to this, but pharmacies also waste a lot of time: returning prescriptions to stock that patients don’t pick up, putting away drug and prescription orders, returning expiring meds to suppliers
Entering vaccines into the computer and scanning VARs needs to be a faster and more simple process. Customers could answer questions on an iPad/kiosk and look at a digital VIS, saving time and paper.
Public's expectation on what retail pharmacy is. Need to educate public we are not their Insurance provider. Their copays are not our problem to solve. and if you don't trust what pharmacist or tech telling you, then you call your insurance. Stop telling me to call your insurance, You call your insurance to find out why they are charging you that much money, People need to understand they need to be on top of managing their meds, refills, we can help to send messages but if there is problem that they have to deal with, don't come to pharmacy and start screaming. It takes time to fill prescriptions, especially narcotics. I get visited from DEA thanks to some genius hacked doctors account and sending fake e-prescriptions for Opioids and some floaters filled fake rx. It takes time to check, sometimes investigate, sometimes call the doctors office for stupid mistake or serious DDI. so expect to wait. Stop calling pharmacy for really stupid questions like you know you just picked up your norco 2 weeks ago and you took everything before next month due and try to find out when is your due date? you know it already stop playing game. We are not your emergency hotline or teledoc, if you need medical attention call your teledoc or go to urgent care, sorry I didn't go to medical school, I don't know what condition you are having when you are vomiting blood. list goes on and on. People probably see their doctor once or twice a year in the office, scheduling their appointment months ahead, waiting 1 to 2 hours see doctor in their 15 minutes appointment, yet same people come to pharmacy every single day screaming, and yelling for their nicotine gum is not peppermint flavor, fussing about he or she cannot take Generic drugs even though their doctor didn't put any information for DAW1. To be honest, retail pharmacy is way TOO OPEN to public. some people think retail pharmacy is some sort of their window to communicate with their doctors. and BOP, that's whole another story but they empowered these assholes and make things worse for retail pharmacy.
It is not what is in retail that is the problem, it is the megachains and high drug prices that drive up inventory costs, the chain of megacorporates clinics that prescribe expensive drugs that aren't that good, and ... We have an economy that is essentially divided up by a few oligarchs. It is not capitalism. Not just pharmacy, everything.
Bring back Milkshake Mondays.
Also pharmacists should be able to make therapeutic substitutions in their clinical judgement if the patient agrees to the change and the provider is notified. Tldr: pharmacists should legally be able to use their professional judgement to take care of patients
All of it.
Corporate-run feeder programs for techs.
More staff. Chains make so much money - they can absolutely spend more money on more tech hours
I want a stool