Tips from a Pharmacist About Pharmacists

Tips from a Pharmacist About Pharmacists

By Amy Hartmann

Amy Hartmann

Amy Hartmann

Editor’s Note: Amy Hartmann is a pharmacist in Oswego, Kansas who read Katelyn O’Leary’s National Pain Report Blog about her frustrations with her pharmacy experiences. Amy’s comments were thorough and sensitive and we asked if we could print some of them as a blog. Happily, she agreed.

As a pharmacist, it makes me sad to hear when any patient (not just a chronic pain patient) is treated poorly by my colleagues. As the daughter of a chronic pain patient, it makes me angry.  It’s one of the many reasons why, after spending 7 years in “big box” pharmacy, I defected to a small, independent store.

Paperwork

If the pharmacy says they haven’t received your paperwork, they probably haven’t.  If the doctor says they have faxed it, ask your pharmacy to contact your doctor to follow up, but don’t expect them to oblige if it’s been less than 24 hours since your request was made.  If it has been at least a day, the doctor says it’s taken care of, and your pharmacy says it isn’t, request follow up by the pharmacy – if they refuse, FIND A NEW PHARMACY!

Monthly Prescriptions

If you get a monthly prescription and the pharmacy chronically runs out, talk with them and find out what’s going on.  There are times in managing inventory that mistakes just get made.  I’ve had drugs on my shelf that I haven’t used in MONTHS and then I’ll get prescriptions for 3 patients in the same day –and I run out. Alternatively, I may have someone get the same drug every month, then suddenly we get a new patient on it too – and inevitably they will try to fill it on the same day when I only have enough on hand for one patient.  We don’t like not having your drug in stock – it makes you mad, makes us look incompetent, and potentially loses us a sale. In the independent where I am now, we can get an order every business day if need be, so I have more flexibility to take care of my customer.  If this “in stock” issues arises time and time again and no one seems to care – OR if you request that the pharmacy call around to find the drug for you and they REFUSE to do so – FIND A NEW PHARMACY!

Customer Service

If your pharmacy EVER tells you they are too busy, dishonest, or lazy to take care of you as a customer or patient – FIND A NEW PHARMACY!  If one of my technicians ever told a customer that we lie about our on-hands to potential customers, they would be reprimanded (if not fired) on the spot.  If I ever hear someone tell a customer it’s “not my job”, they better be prepared to justify their existence in my pharmacy to me, because everything is their job.  With that being said, I don’t think it’s a realistic expectation that your pharmacy call you if there’s a problem with your refill every time.  You can call the pharmacy before you make the trip to see if they have your prescription ready – it might mean another phone call but could help to ease your frustration in making the trip only to find out it isn’t ready.

Insurance Company

Your insurance company may say they’ll approve your prescription at 28 days, which is possible (and typical).  However, you should know many insurance companies also have a rolling window where they count up how early you’ve gotten your prescriptions and how many times – if you are 2 or 3 days early every month for 6 months, that (in theory) gives you 12 to 18 “extra” days of medication.  At some point, your insurance company may deny you on that basis alone.  In addition, many chain stores also have hard-stops programmed into their systems that will not allow a controlled medication to be filled more than 3 days early. However, if you feel as though you are being arbitrarily denied your medication, and its being done with a lack of respect, I would speak with the pharmacy manager about it – if things don’t improve, FIND A NEW PHARMACY!!!

Talk With Your Pharmacist-Respectfully

If your pharmacist wants to speak with you about your prescription, and is doing so in a respectful and empathetic fashion, be candid with them.  Know this. We aren’t your enemy. As you want to be treated with respect, so do we. If I were spoken to by a patient with the hostility that I see related in some of the comments, it might be more difficult for me to maintain an empathetic tone with that person.  I went to school for 8 years to get the degree required to do my job – it doesn’t take that long to learn how to count pills.  I do have training in disease states, drug interactions, and clinical applications of medications.  If I’m taking the time to (respectfully) discuss your medication with you, I promise you I have a good reason.  It could be that you’re filling your prescription early on a routine basis, which alerts me to the fact that you might be taking it differently than prescribed.  Often, it’s because your doctor has told you to, but the problem is that your insurance doesn’t count “verbal instructions” when they figure up your day supply.  Or it could be because you had more pain than usual and had to take a few extra – I get that it happens sometimes.  But as part of my education, I have learned different medication combinations that might help.  Maybe they will, maybe they won’t – but please don’t be offended if I throw out something like suggesting a long acting medication in combination with a short acting drug for breakthrough pain – many prescribers shy away from prescribing long acting narcotics even when they’re clearly indicated and it might help you.  If you show me your pain pump, I will make a note of it, so I don’t make that suggestion to you again in the future.  If your pharmacist doesn’t care or doesn’t take the time to talk to you about your therapy, I would seriously consider finding a new pharmacy.  If at any time your pharmacist (or their staff) is disrespectful to you, FIND A NEW PHARMACY!!

For the chronic pain patient (my mother is one) I understand that when you are under a pain contract, finding a new pharmacy is a lot easier said than done.  But at the end of the day, no patient deserves to be treated with disrespect and no pharmacy, pharmacist, or technician has the right to assume they know everything they need to know about you based on the medication you receive.  It saddens me that many of my fellow pharmacists seem to have lacked training in how to communicate, or they have become so cynical and jaded that they just no longer care.  I truly hope that if I ever reach that point, I’m able to recognize it and move on from the career that I love.

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Authored by: Amy Hartmann

There are 26 comments for this article
  1. Joanne at 4:30 pm

    It’s going to keep getting worse until we fight back with lawsuits.

  2. Carla Cheshire at 9:59 am

    The owner of the Pharmacy is probably the one stealing the pills for himself. I would report him to your State Board of Pharmacies. You’ve done nothing wrong. I would also post on the Pharmacy website and let others know what’s going on. Seems the Powers That Be are leaving People in Pain with no alternative but to fight back. It’s a sad day in our country when the weakest and sickest have to deal with constant anxiety of how/if we will be able to get our prescriptions filled. This leads to more pain. Maybe it’s time for a Class Action Lawsuit for denial of medication and putting pain patients lives at risk.

  3. Dale at 1:46 am

    My pharmacy shorted me 27 10 MG oxycodone so I told the pharmacist and he pretty much called me a lier. I was told by my pain clinic to always have them count narcotics in front of me. Fine for a long time but the nice pharmacist that was hired later finally went somewhere else. Now the old man that owns the pharmacy told all his kids and other pharmacist to tell me and others the DEA prohibits counting medication in front of the patient. I spoke to him and he told me to find another drug store, I told him no other pharmacy in the area was taking new patients with narcotic prescriptions. He said that was my problem not his and if I wanted him to continue I better keep my mouth shut and NEVER ask for a pill count ever again. This pharmacy is full of pharmacist that believe pain clinic patients are just LEGAL ADDICTS.

  4. Kairi Gainsborough at 6:52 pm

    Thanks for the advice about sorting out the paperwork with a pharmacy. I agree that they should be willing to double check their filing system for you if you have waited at least a day since your doctor sent your information over. I can see how it would be really helpful if they are willing to work with you on these types of things. I also agree that communicating with respect is always the best choice.

  5. SJS at 5:37 am

    I did change to a mom and pop pharmacy and what a difference. At the big drugstores I felt like I was committing a crime and would get anxious when bringing my script in. I actually accidentally walked into the pharmacy. The big guy had moved next door and was squeezing out the little guy. I thought I was in big pharmacy and was shocked to find a kind and gentle pharmacist instead of the snarky woman usually there. That’s when I realized I wasn’t in big pharmacy. They had to change location because of the big pharmacy squeeze out and I changed with them. They are awesome and don’t have these ridiculous guidelines. They will partially fill a script (the big guys told me they would have to cancel the rest of it), they will fill a day or so early and they will never ever ever question me or treat me with disrespect. My doctor questioned the change but I had reported every problem at every pharmacy I ever had (I had spent some months driving around in the rain – in pain – looking for someone to fill my script). So they had a record of my frustrations with the big guys and they were okay with the change. I absolutely encourage everyone to frequent the small, independent pharmacists and kick the big guys to the curb.

  6. Deb Stafford at 1:46 am

    Amy, thank you for your artical so very much. I suffer cronic migraine, and have been blessed with pharmacists who go the extra step to make sure the meds will work together, they also help to keep track of my drug allergies. So nice to be treated well finally after many years of put downs and “your just looking for drugs” , that when the store was recently bought by another bigger store, I moved with my pharmacist! They have all gone out of they’re way to help me
    So to all you great ones out there who Really do care, THANK YOU and keep up the good work! You are so very much appreciated😊

  7. Ruth Cobb at 12:09 pm

    I have been waiting for a few months for a refill of my Imitrex Nasal. I was told that there are problems with producer and it would be March that they were be back. I had a bad reaction to Tizanidine, Elavil and Gabapentin with unconsiousness and muscle spasm. I was out of it for several days.

    I have been having migraines daily for 5 years, either mild or severe, and wonder if there is something that could work for I would be relatively pain-free. Zonogran and Topamax caused blurred and double vision so they didn’t work out.

    \Any ideas?

  8. Terri at 5:44 pm

    I use Kroger pharmacy. Both pharmacists know me personally (I went to school with one of them), and go out of their way to be kind and helpful. The techs are great too. This is a good thing since the town I live in doesn’t have an independent pharmacy.

  9. Artie at 11:10 pm

    Question? I recently was prescribed 3 10mg oxycodone day and 2 1mg oxycontin tabs day. I gave pharmacist both rx’s and she filled the 10mg tabs which i rec’d but then she handed me a piece paper w her writing on it which said hydromorphone is what ur insurance pays for so tell ur doctor that hydromorphone is needed as oxycontin is not covered by your insurance? I called left message on friday w doctor office who called monday stating they pushed my pre auth thru and oxycontin was approved? I called pharmacist to ask them if i could pick up rx and they stated they did not have the rx that they gave it back to me? Turns out i think she did give it back to me but didnt tell me that as she wrote on the back of it ie. Hydromorphone and i thought it was scratch paper so i discarded it. I was a new patient at this pain mgt outfit so i didnt bother callin my doc i was worried id be terminated. Im barely making it in the 30mg day 10mg tabs but what should i have done? I terminated my treatment w this clinic 2wks later and my new doc gave me same rx for march 18th this month but i screwed myself again as he has no record of oxycontin being in my history as i didnt fill it so ill be heading into another month short of usual meds crazy on my part i should have just reported it the day it happened ?

  10. Martha Arntson at 4:52 pm

    Donna Gribbins, you are one of the few lucky one’s. I was with an independent Pharmacist, recommended by my Pain Management Doctors. I filled them there for about a year and then when we switched from Aetna to Cigna, he told me “I will lose money if I fill your prescriptions, due to your insurance so I would advise you go back to a Big Box pharmacy”. That was 2 years ago. Back with Cigna, they won’t pay my independent Pharmacist what CVS or Walgreens would pay. So, what is the issue? The Big Pharma?

  11. Donna Gribbins at 12:23 pm

    I am a chronic pain patient and continually had problems 5 months in a row at my big box pharmacy not having my medication. Even though it was a hassle I changed to the small independent pharmacy right next door. He has been wonderful. I drop off my script the day I go to the pain management doctor. He keeps it on file until I need it filled. I just call him when I am down to a two day supply and he gets it ready. I can go get it, or if I am having a bad day and it is harder to get out, he even delivers at no extra charge. I am very lucky. I live in a small town in KY but am thankful to not have that aggravation any longer.

  12. Joanne at 4:42 pm

    Thank you for the advice. The bottle had spilled in my purse (but in a zippered section), so I didn’t want to accuse anybody, but I think I will tell them next time that the last count was off, and I will count them as soon as I get home. A heads-up if it wasn’t an error.

    It’s bad because you know how crazy everybody is about where every pill goes :O But this pharmacy has been very good about everything so far, unlike the Walgreen’s in town (which I boycott).

  13. Amy Hartmann at 2:45 pm

    Joanne – Sorry for the delay – I’m just getting the opportunity to read through the comments. I will echo Sheryl’s advice. Report the shortage as soon as you discover it – ideally the same (or next) day. The fewer times the pharmacy has dispensed the drug in the meantime, the easier it will be for them to track down the discrepancy. If it is a C-III to C-V control, there may be a little more ambiguity because those aren’t necessarily tracked pill by pill. On a C-II, the on hand counts should be exact, so they should be able to see the error pretty easily. If the pharmacy can’t resolve it by checking their on-hands, they should still try to work with you in some fashion, especially if you are a regular patient there.

    And on an unrelated note, thank you for all the kind comments – I appreciate all of the feedback and I hope that at least part of what I have shared will be helpful to this community.

  14. Ronda Carter at 12:43 pm

    Amy
    Thank you so much for this very compassionate, knowledgeable post. As a Stage IV breast cancer patient who is on daily pain meds, I am reassured to hear from even one pharmacist who understands my issues.
    For the person who commented about an inability to find Fentanyl patches, I wanted to suggest that the person check to see if the local hospital has a pharmacy. My local cancer center, part of a local hospital, has its own pharmacy. This definitely takes the pressure off, because the doctor who prescribed my pain patches was simply down the hall (or across the street). I wish this option was available to more patients suffering from chronic pain.

  15. Sheryl Donnell at 11:53 am

    Joanne, if you are ever short, you must contact your pharmacy immediately. I had that happen once. First they told me they couldn’t help me. Then I told them I was calling the local police to report a theft of rx medication and calling their corporate offices. Long story short, they did a recount that night and suddenly found my missing 42 pills. In your case it nay have been an error, but it can also be a problem employee. You must report it ethically.

  16. Semia at 11:27 am

    Amy- Thank you for taking the time to write such a thoughtful and intelligent letter. I am also grateful that the National Pain Report passed it on to us. Thank you for important info to make me a more informed chronic pain patient.

  17. Sharon at 8:49 am

    Amy, can you move to Memphis??? After seeing that ridiculous video of pharmacist or pharmacy tech singing about people who need medication to help them through their days I was so taken back by the “pharmacy world”. Thank you for bringing me comfort and trust that just as there are people who don’t take medication as directed, there are pharmacists and pharmacy tech who do care!!

  18. Carla Cheshire at 7:03 am

    Thanks for writing this, I learned some important information. One thing though, for chronic pain patients with prescriptions for narcotics it is sometimes quite difficult to find another pharmacy that will carry these medications. I was recently told by a CVS next to the Houston Medical Center that they no longer carry Fentanyl patches. This is one of the largest medical centers in America. So many pharmacies refuse to carry narcotics, the private ones too. Are they afraid they will be targeted by robbery? I call ahead and ask if my narcotic medication is in stock and I’m told they will not give out that information. Every month getting my medication is an adventure. Mostly not pleasant.

  19. Martha Arntson at 6:59 am

    Amy Hartmann, in Oswego, Kansas, THANK YOU THANK YOU THANK YOU for writing this blog for all of us who have had “incidents” with their Pharmacy or Pharmacist. I live in KS but too far to utilize your pharmacy because if given the opportunity I would race to your business this month for sure! You clearly explained, from your perspective as a well trained and empathetic Pharmacist, that not ALL Pharmacists treat their pain patients as has been described in some of the prior blogs regarding this issue.

    I, for one, have been treated badly by the larger chain drugstores. When I went to the recommended “independent pharmacy” (by my Pain Management Doctor), it was great! Hands on, one Pharmacist who cared, a couple of his family members worked alongside him, mostly older patients I would encounter there because he is located in an area of town that has a lot of nursing homes and older homes that the population is primarily elderly. And he has been in business for 30 years in the same area, he knows his patients, he talks with them (me) privately if there is an issue with something. A very small store but he made a place for patients to sit with him and talk about something important. Then we changed insurance companies. Here comes the reason he can’t fill my prescriptions anymore, MONEY. He sat me down, stated “I would not make a dime on your prescriptions anymore with this change in insurance, in fact I would lose money”. I was stunned, then he explained the Big Box pharmacies can afford to stock and fill particular prescriptions because they are covered under a Corporation, where he as an independent cannot afford to do so. That is a huge issue with me. How come Insurance companies can dictate where I fill my RX? To me, it seems it’s about money and not the patient.
    I had to go back to the Big Box pharmacy to fill and I get the same reaction every month which is “let me see if we have that many and oh, the insurance company might not cover it until 2 more days”. EVERY SINGLE MONTH this happens.

    Frankly, I am tired of it, I get anxious at the thought of even going to the pharmacy anymore because I know what they are going to say. No matter WHAT my doctor writes on the RX, they ALWAYS haggle over it. And I’m not on anything other than a minimal amount of a narcotic, that was a Schedule III and now re-scheduled to a Schedule II.

    What is a person to do, as a chronic pain patient and customer of these stores, to get the kind of empathy and concern that you have written about so eloquently?

    Thank you kindly for your great post!

  20. Wendy Warren at 6:33 am

    Thanks for the tips. It’s not always an option to switch pharmacies, like for myself not only do I have a pain contract but I also do not have a lot of choices for pharmacies around me. So I give my pharmacy as much advance notice as possible, and I also contact the doctors office to get things done. Every little bit helps.

  21. C.D. Starkey at 5:57 am

    My husband and I switched to a different pharmacy after a problem arose. A pharmacist lied to me about filling birth control pills. This was 2003 and I caught this young man in series of lies including that my insurance denied it. I called them and discovered the first of many lies. I’ve never had to do this since but I called the regional supervisor about him. She drove an hour and a half that day to personally fill my prescription! I don’t know what happened to him but I never went back. Not long after that I heard a news story on the radio that a law in Georgia protects pharmacists from filling birth control if it is against their religion. I don’t know if that’s why but you’d think he’d at least be upfront about it.
    In any event it was a blessing, the pharmacy we’ve been going to ever since has been wonderful to us!

  22. Dave at 5:40 am

    We should call for pharmacies and pharmacists to be more responsive to the needs of individuals. Dealing with pharmacies and pharmacists should not be burdensome and people in pain should not be disrespected. We should call for more oversight over pharmacies and pharmacists and more fines and penalties when they create problems for consumers.

  23. Brooke at 5:00 am

    Great article! Thank you for sharing with us.

  24. Debra Rector at 4:51 am

    I really loved reading this post.I have changed pharmacys before due to the treatment I recieved.Im a chronic pain patient as well and it’s humiliating and fustrating to be treated as if I’m there seeking meds because I’m a drug addict! The pharmacy I went to, most of the pharmacists became rude and talked down to me . They made me feel as if I was a bother to them.One day I called to ask them a couple of questions I had, so I started with stating my name and the pharmacist says “Oh we all know who you are”, I was so upset by the tone of his voice I just hung up and cried.That was it -I was done with them! I changed pharmacys after that! Been having much better service since.Its embarrassing to me because I have about a dozen different kinds of meds and its time consuming to change but so glad I did! No one knows what your health issues are,but you and your doctor.No one deserves being treated rudely because of your health issues.So glad you posted this and I thank you for letting me vent!

  25. Joanne at 3:47 am

    Great article, thanks!

    I have a question for you. When I counted my pain pills the day after I got them, I was short 8 (as in 8 were missing). I didn’t report this to anybody, but I’m concerned that it may happen again. How do I deal with this situation when I get my next refill (and my state required me to specify and use only one pharmacy)?

  26. Angelica Heavner at 3:31 am

    Amy Hartman thank you for being one of the few ethical pharmacists. I have had several like you and also more of the horror ones. I see a pain management doctor in one state and live in another (maybe 30 miles away). It makes it difficult to get mine filled. The one state wont fill it because the insurance and license is for another state and the state I live in doesn’t like to fill it because its written from another state. To change doctors the closest that excepts my insurance, but wont guarantee to give me my prescriptions (which I have been on for 5 yrs) is a 4 hr drive away. No possible way I can handle going that far away once a month for a doctors that may not give me my meds then I wont be able to fill at home because its over the 50 mile radius the pharmacy will fill for.
    I have been questioned 6 times at the same pharmacy for the same med. I no longer go to that one because of it. I have also had the same prescriptions triple in price from one mth to the next. No one can explain that one.
    So thank you from a chronic pain patient for your time and effort and conscious. Its appreciated from alot of us.