Don't Be That Pharmacist

Dear Pharmacist,
This is a note to THAT pharmacist. You know who you are. You have spent your entire career, long or short as it is, setting our profession back. You have made us the prescribers' bitch. While I have written many a post denying that moniker, it is thanks to you that I still have to argue for respect for my profession. This diatribe is for you.

Don't be an idiot.
Think for yourself.
Make your own decisions.
Life is not about doing what people have told you to do. It is about thinking for yourself and doing what you know is right.
You and I went to school. I paid someone to teach me HOW to think. When I graduated I took a test. Upon successful completion of that test, my State Board issued me a license. They told me to go forth and use my knowledge and license to make informed decisions.
Apparently you were told to go forth and question everything and to not make any decisions on your own. Apparently you were taught WHAT to think instead of HOW. Thank you again for leading to further erosion of respect for my profession.

If a prescriber writes a prescription for a Proair inhaler, am I allowed to switch to Ventolin (or vice versa)? Not exactly. However, if a patient's insurance only covers one and not the other then I am going to substitute appropriately, document the insurance requirement then, maybe, call the prescriber in the morning to inform her of the formulary change. This is how it should happen. Prescribers don't care. My state board does not care. Did the patient receive Albuterol HFA? Yes? Good. Well done. That's why you went to school and received a license from us. Pats on the back all the way around.

A prescriber asked me how to avoid all of these stupid phone calls from pharmacists asking permission to change Proair to Ventolin or vice versa. She does not care which one her patients receive. She can't keep up with the formularies. All she wants is for the patient to receive an(y) Albuterol HFA inhaler. Period. I told her to write for "Albuterol 90mcg HFA" and the pharmacist could then try Proair or Ventolin and, if not covered, switch it to the preferred without bother.

Or so I thought . . .

Until the next day when a pharmacist checked one of her prescriptions.
It was written exactly as I had instructed: "Albuterol 90mcg HFA MDI". So easy. So unmistakable. How could a pharmacist fuck it up? By leaving the following message on the rejection: "Rejecting this for you to call the doctor. Please call prescriber to clarify because there is no generic available. What do they want us to dispense?"
Are you serious?

Now remember, until yesterday when I got this prescriber to write "Albuterol MDI", if she had written "Proair" or "Ventolin" and I needed to change it, this exact same pharmacist would have sent back a message like this: "Where is the documentation that the prescriber was called? Did doctor approve the switch? No notes."

Thanks. As I already made clear: I. Don't. Have. To. I am licensed to think freely and make decisions with my license. So are you. I am legally allowed to do what I did. So are you. I told the prescriber to write "Albuterol HFA MDI" because of YOU. YOU keep calling prescribers like her and pissing them off. YOU make it seem, in their eyes, like we are incapable of making effective healthcare decisions for our patients without having our hands held and bottoms wiped by these prescribers.

I call offices about important questions and the first things they ask are: "Is it a tablets to capsules question? Proair to Ventolin?" YOU have trivialised our job so much that we can't get respect from offices, yet we wonder why they don't take us seriously when we call about REAL interactions. About real errors on prescriptions. No wonder they don't have time for us, we wasted it all calling on bullshit.

Use your brain. Use your license. Make a decision for yourself. Or come to my store and I'll show you how to be a pharmacist.
And stop disrespecting my profession.

#IfThisPissesYouOffThenItIsAboutYou