Older Pharmacist, pharmacists' attitudes, pharmacy

After 17 years working in a pharmacy, I notice many of the same issues over and over, many of which can be easily prevented. I have collected tips over the years, and recently gathered some more from my pharmacy colleagues. Here are some tips, in no particular order, to have the best experience at your pharmacy.

Be Thoughtful about the Pharmacist’s Time:

First and foremost, please do understand how busy and stressed we are behind the counter. A great reminder of our day: https://www.peoplespharmacy.com/2018/08/02/why-we-cant-just-slap-a-label-on-it/ and the first don’t – don’t ask us to just slap a label on it!

Do know that pharmacy is not like fast food – everyone wants everything right away, but any mistake can be fatal. Please do not rush your hardworking pharmacy staff; they are doing the best they can.

Do call ahead for refills if possible, and also, check the bottle – if the prescription has no refills or if the prescription is expired, the pharmacy will need to contact the doctor for a new Rx. In this case, even better if you can call several days ahead to give the doctor time to reply to the pharmacy’s refill request. Take responsibility for your health. If we have called your doctor 3 times for a refill and they have not replied, you may want to try calling as well.

We don’t mind ringing up a few items, but please don’t come to the pharmacy with an overflowing cart and say, “Can you just ring this up here, there’s a line in the front?”

Plan Ahead:

Please know what you want to refill – so many people call and say, “refill everything!” and then arrive at the pharmacy saying, “put this back, put that back.”

Most prescription items are carried regularly in the pharmacy, but there are a handful of medications that often need to be special ordered. If you know that your medication was specially ordered in the past, always call a few days ahead. Be prepared!

Always have your most recent prescription insurance card. Sometimes, both the medical AND prescription information is on one card, and sometimes you will have two different cards. In that case, the medical card is useless at the pharmacy. Be sure to bring your prescription card – it should have a BIN and PCN number as well as some words like Rx, prescription, pharmacy, etc.

Please give us your full attention, and end your private phone calls before approaching the pharmacy counter. We don’t want to give you the wrong prescription because you’re too busy gossiping with your friend and you aren’t fully paying attention. Also, HIPAA!

Please know that although your doctor means well, he/she doesn’t know how long the prescription will take to arrive at the pharmacy (electronic prescriptions may arrive anywhere from immediately to several hours).

Therefore, it is a good idea to call before you come in to see if your prescription is ready. Doctors also do not know how much your prescription will cost. This is not an insult to doctors – the pharmacy staff also does not know how much your medication will cost until it is processed electronically through your insurance.

Know Your Insurance:

Do understand what a prior authorization (PA) is. I find this to be a very poorly understood concept. Most patients think the authorization is the prescription written by the doctor, and blame the pharmacy for the delay. However, it really means that the insurance needs more clinical information from your doctor before they will pay for your prescription. Often, it is to your benefit to follow up with your doctor on these as well, because doctors are likely up to their ears in prior authorization requests.

Do be understanding if we have to call your doctor to clarify something. A missing quantity, sloppy handwriting, a drug interaction, etc. – all of these need to be clarified for your safety.

Follow the Instructions on the Prescription:

Do follow directions as written on the prescription. If your doctor changes the dose, that is fine – just have your doctor call in a new prescription with the correct dose. If you are taking Lipitor 10 mg and the doctor tells you to just take two a day instead of one, you will run out early and have problems trying to refill it.

Following directions is especially critical on controlled substances and narcotics, such as Vicodin, Percocet, etc. Many times, patients use the medications too fast, and due to company policy/state and federal laws/insurance/our license, we cannot fill these early. If your doctor writes the prescription for 1 tablet every 6 hours, but you need it every 4 hours, don’t be shy about talking to your doctor about changing the directions/quantity or adding/adjusting a longer acting medication.

We don’t mind when you wait for a prescription, but please stand to the side, browse the store (we will page you), or have a seat in the waiting room. Pharmacy staff do not enjoy being stared at while working.

Do call your insurance if you have a question about the price. The pharmacy staff enters the insurance information, the claim is sent electronically, and the price prints out without the pharmacy staff entering a price at all. You may have a deductible, or if you have Medicare Part D, you may be in the donut hole. It’s always good to check with your insurance with these questions.

We Can Help You Save Money:

Do use generics when possible! As a pharmacist, I always choose generics for myself when buying over the counter products, and prefer generic Rx items, to save money.

Do ask for advice on over the counter meds. We are glad to help. Just don’t say, “ok thank you, I’ll buy this down the street, it’s cheaper.”

Work with Your Pharmacist:

Do be proactive when you go on vacation. Most insurances can work with the pharmacy to provide a vacation override. However, it makes things difficult when you show up an hour before your flight with no refills and you’re too soon to fill the prescription anyway.

Do get to know your technicians. A pharmacy cannot run without efficient, smart technicians. They can help you with almost anything.

Be loyal! Use one pharmacy, so we can keep track of any drug interactions.

Do use the automated system/app/text messaging to refill your prescriptions. They are effective and save time.

Do use the pharmacy for your vaccine needs! It is easy and convenient. Even better? Call ahead and ask when the best time is to come in.

Do double check with your pharmacist if a medication looks different than before. Most times, it is just a change in manufacturer, but it’s best to be safe to make sure an error did not occur.

Pharmacy Etiquette:

Be respectful of the pharmacy’s operating hours. If you go to a grocery store or bank that is closed, you go home, but people tend to expect pharmacies to stay open way past the operating hours. If the pharmacy closes at 9:00, don’t show up at 8:55 with 5 prescriptions from two weeks ago and ask to wait.

Do be patient! We are working as hard as we can, often in an understaffed situation put upon by corporate, and the time it takes is for your safety. A smile and patience go a long way from both of us!

Don’t knock on the counter, say things like, “Hello? Anyone here?” We are getting to you as fast as we can!

Don’t come to the pharmacy AFTER grocery shopping, and then become upset when your ice cream melts in the trunk. Also, don’t ask us to hurry because someone is waiting in the car. It’s best to go home, put your groceries away, drop off your husband, etc., and then come back.

Do ask questions and don’t be shy about it! We are here to help you. We want you to understand your medications and are always happy to help.

A Special Section on the Drive Thru

Do be patient. Drive thrus are for convenience, not faster service. Please do not ask to wait for your prescription in the drive thru. Patients are continuously coming and going, and we can’t hold up the line for patients to wait. Most pharmacies have spaces (or the parking lot) where you can pull over and wait, and get back in line when you get an automated call or text that your prescription is ready.

Secure your money in the drive thru window. For example, place dollar bills under the pen, otherwise your money could fly away. Also, don’t just throw 200 pennies loosely into the window.

Please do not ask the pharmacy staff to get nonessential items from the drive thru. Tylenol for your sick baby- absolutely. Potato chips- nope.

Do come in and talk (or call!) if you have extensive questions – again, it holds up the line. If you need to talk to the pharmacist for more than a few minutes, no problem, just don’t hold up the line of cars.

Please do not talk on the phone while in the drive thru. It is hard enough to hear our drive thru patients through staticky intercoms, we can’t compete with your other conversation, and besides that, it could violate your privacy.

Please do not honk or smoke in the drive thru. Be courteous and kind. Turn down your music and focus on the transaction.

Do respect the staff and come to the drive thru during operating hours. If the pharmacy closes at 9:00, be at the drive thru by 8:45 at the latest.

Be ready when the employee comes to the window. Please don’t ring the bell and make the busy staff wait while you shuffle through your purse looking for your prescription or insurance card.

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  1. Mark
    Florida
    Reply

    “Someone will be with you in a moment.” ( but it ain’t gonna be me. I’m a tech not a cashier. The pills I’m counting and the bottles I’m shelving are more important than you. I don’t care how long the lines are.)

  2. Jules R.
    Reply

    It is bad enough when a health insurer has restricted access to choice of medication, but now pharmacies do also. What good is it to know origin of your meds if the corporate office of the pharmacy chain refuses to offer anything else. The reason of course is that the inferior meds are cheaper for them, and they couldn’t care less about serious health issues they can cause you, even if they lose a customer if the meds actually contribute to your death. Kroger is a prime example. The source of their meds not only provided grossly inferior product but even mislabeled it. No matter. Kroger still offered no alternative even when the pharmacist was able to provide the evidence of tainted product and mislabeling.

  3. SALLY
    MO
    Reply

    We had a bad experience with a major name brand pharmacy. They were severely understaffed and did not give immediate attention to customers waiting. We’ve had best luck at our grocery pharmacy.

  4. Ruth
    Charleston, WV
    Reply

    My best experiences have always been with independent pharmacies, professionally & personally. Hands down!–retired RN

  5. Karen
    NY
    Reply

    As a pharmacy technician for 30 years, you NAILED IT on EVERY point. Thank you for this!

  6. Chaela
    Denver
    Reply

    People in every city of 50,000 plus need a 24 hour, 7 days a week pharmacy within a 20” drive, as well as 7 days/week home delivery service. Most customers would appreciate their pharmacy increasing staff by 20 to 50%. All customers should be given no more than a 10” waiting que when they have phoned their pharmacy 12 hours ahead to insure their rx has been filled and is ready for pickup.

  7. Susan W
    FL
    Reply

    This is a great article and it should be posted at every pharmacy where customers can read it WHILE THEY ARE PATIENTLY WAITING.

    A few months ago I had a terrible experience with a pharmacist who was new to my pharmacy and I’d never seen her before. I had called in a refill for Ativan on the automated service at the appropriate time and was told I could pick up the refill the next day.

    I went in the next day and the new pharmacist retrieved it for me. It had been filled, approved by my insurance, paid for by a card I had on file, and it was bagged and stapled.

    She started to hand it to me, and as I reached for it, she suddenly drew her hand away and said loudly (in front of 4 or 5 customers who were waiting), “I CAN’T GIVE YOU THIS!”

    When I asked her why, she stepped back and said, loudly, “THIS IS A CONTROLLED SUBSTANCE–A SCHEDULE 2 MEDICATION AND IT IS A VERY LARGE ORDER!!”

    She had decided, that even though the med had already been filled, that she was not going to give it to me for reasons she could not make clear to me.

    I felt embarrassed and humiliated as her attitude implied that I was trying to fill a controlled substance too early, making me look like an addict.

    I have been taking the Ativan at that dose (2 mg), and the same quantity (4 x daily, or 120 pills) for many years, but apparently she did not bother to check this. I am 73 years old and I had never been treated in such a disrespectful manner.

    She made no attempt to speak to me privately and quietly.
    I became very angry and an an argument ensued which led to her threatening to “fire”me from Walgreens (meaning ban me from WGs).

    In frustration with her arrogant behavior and her blatent violation of Federal HIPAA Laws concerning patient privacy and confidentiality, I tossed a plastic pen that lay on the counter and left.

    Nearly two months later a police officer came to my home to tell me that the pharmacist had pressed charges against me for striking her with the pen.
    The officer showed me a “selfie” she had taken of her face right before the police came, and as a retired RN, I could plainly see there was no wound: no cut, bruise, blood, or swelling. What I saw was a dab of Betadine on her forehead.
    The officer said he had put off taking my statement as long as he could in hopes that she would drop the charges against me of Battery 1.
    There was a surveillance video of me tossing the pen but not of it striking the pharmacist, which was never my intention anyway.
    She refused to drop the charges and I ended up being arrested and sentenced to house arrest for 45 days as punishment for my “crime.”
    She even lied in her written statement for the police (under oath) and stated I tried to get her to “fill a narcotic one week early.”
    I never asked her to fill anything as my refill had already been filled by a different pharmacist, and I don’t think most people think of Ativan as a “narcotic.”
    As she banned me from Walgreens I now have all my meds filled at a non-chain family pharmacy. The head pharmacist at this pharmacy, when he heard my story, advised me to report her to the WGs Regional Manager. I have not done that yet as I am still under house arrest, but I plan to do that as well as file a complaint against her with HIPAA.
    One last thing: Ativan is NOTa Schedule 2 medication. It is a Schedule 4, the least restricted. The customers listening to her tirade that evening may have had knowledge of scheduled meds and could have assumed I was taking something like Oxycontin, or some opiate-based medication that has caused so many overdoses and deaths.
    As I have Generalized Anxiety Disorder and Recurrent Major Depressive Episodes, this experience was especially difficult for me, at age 73.
    The pharmacists at the family pharmacy I go to now are always very polite and they have a private drop off section, away from the cashier section.
    Walgreens had a private window for consultation with a pharmacist but they had put a huge arrow over it, directing customers to the cashiers, where you could easily hear infomation about other customers’ medications or medical conditions. There was no place for a customer to speak privately with a pharmacist.
    I was traumatized by the experience at WGs, the subsequent hearing before the judge, and being placed on house arrest after the pharmacist gave her “victin statement” in which she lied under oath again by stating I had returned to WGs the following day–I did not. I did call to find out what they did with the Ativan as I was concerned it would mess up my insurance coverage.
    A month ago I called a different WGs to find out when I last filled a script for Ativan there, and there was no record that it had ever been filled on the day I had gone to pick it up.
    If you go online you will find that WGs has been sued multiple times for HIPAA violations.

  8. Tim
    VA
    Reply

    Let me add to this article: If you wonder why you are told that the prescription you just brought in will be ready in 45-60 minutes and you don’t see any other pharmacy customers waiting, it’s probably because someone came in just before you did with 5-6 prescriptions and said they will be back in 30-45 minutes to pick them up.

  9. B.V.
    Chapel Hill, NC
    Reply

    Excellent piece that provides great information we don’t get elsewhere. We wish our local pharmacies would sendout this kind of practical advice.

  10. GW
    Calif
    Reply

    How about the other side? Here is what I believe the pharmacy can improve upon:
    1. Do not “robocall” me when you think my prescription refill is due. It is usually not the right time.
    2. Ask me if I prefer to know the place of manufacture of the drug. Many of us do not trust medicines manufactured in China, India or Philippines. If not known, so state that on the label.
    3. Do not give me a receipt that is longer than my leg.
    4. Offer home delivery by mail or carrier for those not mobile enough to come in.
    5. Acknowledge that I am waiting – “we will be right with you.”
    6. Clearly identify yourselves as “senior pharmacist”, “trainee” or “store clerk.”
    7. Smile and be polite – we know you are busy but every customer deserves respect and kindness no matter how bad your day is going.

    • Tim
      VA
      Reply

      The robocalls are a corporate thing. Actually some of our patients like them. Your pharmacy staff should be able to get you off the robocall list. Talk to them about it. We want you to be happy. It makes it easier for us.

    • Karen B
      Nj
      Reply

      Yes I love this! I will definitely work this into a future article!!!

  11. Doc Wally
    St Lucie County, Florida
    Reply

    As a pharmacist, I care about my patients and chose to be in this rewarding career. I agree with all the above statements. Please respect the Pharmacy is our office and the staff is our family away from home. There is so much going on behind the counter in regards to filling prescriptions, calling MDs, calling insurances, ordering, stocking, inventory monitoring, vaccine prepping and administering, counseling at the counter-over the phone-in reports, and yes the phone never stops ringing so you may have to wait til the pharmacist is off the other line or done ringing up another at the register or done counseling at the drive-thru. Patients please have patience, just as we have when reviewing prescriptions to avoid interactions/errors/billing notations/day supply preference/brand preference/pick up time/stock/manufacturer coupons/and all the interruptions that occur while filling just one RX! An average day is 10 hour shift with no restroom or meal break. We work nights, holidays and weekends all year long. How would you like that?!? We chose this for the most part in retail yet still have empathy-patience-consideration-connection for our customers. I personally have a handful I consider my hero for what they have endured and conquered medically. Also there are some I can live my day without, like the ones who throw items at my head, curse horrible things, bang on the counter saying slap a label on it, statements of been on it for years just give me more, honking in drive-thru when has been already greeted and can see the tech is ringing another up at counter, people can be mean-please don’t be that one. We are here for you and your health needs and are wanting to give you our attention and expertise from our education and experience. We are no different from our patients, we get sick, we get hungry, we need to use the restroom also – so don’t follow us in there to demand your Rx Instantly-awkward! If you don’t know your current dose-how will we? One of us will have to call your Dr. Stop complaining – say thank you! When the Dr sends in an Rx it gets put into a que of all rxs in the order they were entered, not to the front of the line. You may call ask for it to be placed earlier-that’s fine and we will accommodate. Driving right to th Pharmacy from the Dr office does not make th Rx ready, we may not yet have received the Rx into process yet, but you can ask when we do that we process sooner than where is placed in the que-we will accommodate. Opt in for the text message alert and/or the mobile app, it is so beneficial and can put the control in your hands of what is filled and when and the cost prior to arrival for pick up so the drive-thru pick up line stays as should be-express pick up or drop off-not ask a million questions, hand in a bunch of different discount cards to run, shopping list, shuffling through the car or purse for Rx or money or insurance card and then get cranky when asked to come inside or pull around so we can do the insurance rebelling as you requested or complete the Rx now we know you want it sooner than later. I can’t express how many rxs are wanted right now yet are not picked up at all and put back to stock a week later. That’s extra work when we could have tended to another quicker. We ask you be considerate to your Pharmacy staff as well as other patrons.

  12. Jack
    Missouri
    Reply

    I had a good laugh at the statement to get to know your technician. I never see the same person twice where I shop.

    • Debi
      North Carolina
      Reply

      Good points!

  13. Joan
    West Seneca, NY
    Reply

    Thanks you for the do’s and don’t reminders. I find myself guilty of some and we all need reminds. I am a retired RN and appreciate the work and professionalism I have experienced in the Pharmacists I have dealt with over the years. Today’s attitude of wanting things now now now is a challenge for everyone. Patience is a gift we need to use often. Thanks for the reminders

  14. Ann
    Siler City, NC
    Reply

    What a great article. I’m a nurse, not a pharmacist, but I’ve observed every one of these rude behaviors in the line in front of me at my pharmacy. I’m interested in getting a copy of this article to share. Is that possible?

  15. Kirk
    St. Paul, MN
    Reply

    Excellent article. Also reminds me why I got out of pharmacy. It takes special people to run a good retail pharmacy these days. Thanks to those who do it, I had my fill of it after 30 years.

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