A Non-Pharmacist By Another Name Could Be Called A Technician
Poor Suckers Actually Believe This Kind Of Hype. They believe that their Junior College (Or high tuition for-profit school) is going to make them a “Pharmacy Professional” on day One. Most of them come out of “college” not knowing how to answer the phone, choose the right generic or how to fix a a PBM reject. Only three important aspects of the Technician’s job. What is really ridiculous is the expectations that their “college” brainwashes them to believe. They actually expect to make $16.00 an hour right off the bat. They expect their job to be “professional” and important. (First the job of a Technician is not a “Profession”. It is a “Trade”). Second, a kid right out of “Technician College” completely unprepared for retail. They need to be trained on-the-job. Why spend way too much money to go to a “college” in the first place.
All of the Technicians I work with were trained on the job. All of them are Efficient (They do things right). They are also Effective (They do the right things). All of them are “Certified” and the jury is out on the value of certification. Especially in retail. We have two girls in the store who are “Certified” who do not work in the pharmacy because they can’t hack it. Occasionally, they are asked to come back to cashier.
Now, a story that indicates that Technicians need to remember their place. They are not pharmacists and they need to mind their own business.
Sorry for the insult, but is it really an insult to point out the wart on the end of your nose, if there is a wart? The way this business is progressing (and the fact that the shortage is dwindling), do you believe that you can still make six figures if all you are is a “Warm Body With A License”? You cannot delegate your professional responsibilities and the Eric Cropp incident is a cautionary warning. You may not allow a child to die, lose the privilege of practicing pharmacy, become a scapegoat for the OHIO legislative and regulatory failures and be thrown into jail to do hard time and be a girly girl friend for a six foot five, 280 pound guy they call “Bull”, but your ass could be grass if you allow a Technician to do anything that comes close to practicing pharmacy.
Technicians can become really comfortable. They hear you saying the same thing over and over when you are counseling. What can be the problem with advising a patient with the exact words you use? First: it is illegal. It is practicing pharmacy without a license: Second: It diminishes your role as the professional. Third: the technician can get it wrong. Especially if the patient asks questions. Tom, a mature man, is a smart rat technician. He barely listens to them. ”You need to talk with the pharmacist,” he tells them. He gets an inordinate amount of questions because he is not a kid and they think he is a pharmacist.
I learned to listen to everything when I managed a small drug store in Pacheco, California. My ears were still good. I was in my early thirties. Age and lots of loud rock ‘n roll, back in the day, leave me saying, “huh?” “What did you say?” or “Please speak up”, especially on the phone and forget it if they are on speaker.
In Pacheco, I caught a pharmacy technician giving a personal friend a discount on an OTC item. A giggly blond stood off to the side planning a weekend liaison with a guy who drove a Corvette, dressed like Joe Namath and was married. They were meeting at The Sahara Tahoe Hotel at South Shore Lake Tahoe. I didn’t say anything until we worked together one evening. I was masterful bringing up the dangers of conducting an affair with a married man.
Too many times, I have heard a Technician giving medical advice and counseling on Rx Only or OTC drugs. That shit does not fly. I am all over them. Not on my watch. The pharmacist who overtly allows this or covertly looks the other way is an idiot. This is your turf. Protect it. If your don’t protect your turf, you may lose that turf. The entire profession could lose its turf. Our situation is precarious. Pay attention before the lemmings rush you off the cliff.
This weekend, the Technician was at the drive through and I heard this: ”Take one pill today and one tomorrow.” It was pretty clear what was being sold, so I asked.
“Plan B”
I said, “I do not sell Plan B at the drive through. She has to come in and be counseled. I will do it all, including the cashiering.”
I got the distinct impression that the technician was a bit put out, but tough shit. I don’t mean to offend, but if that happens, the technician has a grandiose self image and that needs t o be squashed.
I have written about the value of Pharmacy Technicians many times. (Here and in Drug Topics) I believe that we cannot do without them. They are not paid enough. Period!
Counseling on “The Morning After Pill” is a no-brainer. You confirm that it has been within 72 hours of the event. You tell her to take with food to prevent nausea and vomiting. It is a hormone, after all. If she vomits in the first three hours after the taking the dose, she has wasted $44.99. She has to come back and buy another box. I make sure that she knows that her breasts may become tender. It is a hormone. I tell her that her period may come early or late. It is a hormone and hormones are the directors of the symphony. I ask if she has any questions. Then I take her money. (If the young man who enjoyed her impetuousness and lust does the paying, he is a very cool guy).
Now, this is going to get fun, you guys, watch the comments. In the past, I have “Punched My Ticket To Hell”. I Have been accused of being an atheist . I am not, by the way. My spirituality is my business, but it does not include Yahweh, Jehovah or God. I do not believe in the divinity of Jesus Christ or Mohamed. I was raised as a Christian in time when most communities were Christian. So, I quite naturally am guided by the rules, proscriptions and generosities of the way I was raised. That being said, I assure the young woman buying the Plan B, “THIS IS NOT ABORTION”. For some girls, this is a relief. Others, it is Ho Hum.
Later, when we were not busy, I said, “About the Plan B”. I made eye contact. ”You do not need to take that kind of liability.”
“How so?” (meaning what liability?)
“How did you tell her to take the second pill?”
Oh oh. I could see the wheels turning. Is this a trick question. ”Tomorrow.”
“No.” I let it linger like a turd in the punch bowl. ”Twelve hours. Whose ass goes down if she gets pregnant after not taking the pills properly.”
The eyes showed fear, danger, embarrassment. ”Mine.”
Yeah, I thought, but did not say, No, it would be my ass.
“You do not need that kind of liability,” I repeated. ”If the other pharmacists ask you to sell this, I recommend that you zip your lips and tell them to read the box. Nothing more. If she has questions, you call the pharmacist.
Think about it. Your professional life depends on your acting like a professional. If you think your job is minding “The Mill” and doing none of the “distractions” that federal and state pharmacy laws regulate, expect your wage to eventually be reduced to 60% to 80% of what it is now. Tell your husband that the BMW that he has been dreaming about may not fit in the new budget. That timeshare in Cancun. Sell it when you can get a good price. The golf membership? That’s big money that is the 40% to 20% that your non-professional behavior will lose.
The private school for your kids? Keep it. Your children must have a good education to survive in 21st Century America. But, Jay Pee. How can we afford it? By giving up some stuff.
The best way to get a professional wage is to act like a professional. If you get push back from your metrics-obsessed company, document everything and take our friend Pharmacist Steve’s advice . Send emails asking for clarification. Ask where you can find guidance in the company’s published Policies and Procedures. Always, as Steve advises, copies of everything goes to the company’s Chief Compliance Officer.
Pharmacist Steve is the National Public Relations Director for The Pharmacy Alliance. I will suggest to Steve that he writes a manual on how to do this. Steve is a very bright guy who has been around the race track a few times. It is guys like Steve who can help us get our feet firmly back in control of this game.
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I often wonder why any sane person would voluntarily become a pharmacy tech. It is a terrible,low-paying dead-end job. At least we as pharmacists get paid well for our terrible dead-end job. That being said, I have the utmost respect for those who do choose this job and do it well. I have worked with dozens of techs. in my time and the majority of them are hard-working, responsible employees. Sure, you get some that don’t listen and fight you every step of the way but that occurs in any working relationship. I agree that the job can only be learned while performing it. This schooling non-sense is a money grab by these institutions who use the “healthcare profesional shortage” to lure in “students”.
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The most disappointing thing is that the corporations refuse to pay techs. a decent, livable wage. There’s no reason a good tech. shouldn’t make $16.00/hr as their responsibilities entitle them to at least that much. Instead the corps. choose the “revolving door of retail” business model where someone who can’t or doesn’t want to do the job is replaced with someone else who can’t or doesn’t want to do the job. There is no reward for a job well done in retail pharmacy just increased and unreasonable expectations.
Techs can be a blessing or a curse… the ones that don’t really belong working in a Rx dept.. for various reasons… no matter how much you try to get them up to speed.. it doesn’t work.. some at the other end of the spectrum – very bright and competent.. can equally be a curse… they develop a self confidence level of their competence and if you don’t “rein them in” well go off on their own.. and the more slack you let them have .. the more they will take.. before long they believe they are on a status level with the RPH.. then you really have a problem.
A properly trained tech, who understands the limitations of their job description/title… are invaluable to the RPH and should be paid more than they typically are.
If you – as a RPH – have not read the corp’s P&P manual… read it… then read it again and again… recently a CVS RPH read theirs and sent me a page from that P&P manual that CVS ENCOURAGES RPH’s to take 15 minute break per 4 hours worked
you can find it here ..
http://healthblog.steveariens.com/?p=881
WHO KNEW??
What else is hidden in a company’s P&P that they really rather you not know?
HR/Chief Compliance office is the “P&P police”.. if you have a concern about something being done or not done that is required by the company’s P&P… they are the ones to go to.
If you are a Rx dept staff (RPH & tech).. and you have a problem with the RX dept’s operation.. especially something that puts patient’s health and safety at risk… do you have a obligation to file a complaint/concern with both HR/CCO and the BOP?.. the PIC is responsible – by the practice act – for the legal operation of the Rx dept.
If the PIC is going along with some corporate mandate that puts patient’s health and safety at risk… he/she could be putting your license at risk..
Do you have a legal/professional obligation to alert the BOP?
Just look at a common quote from a corporate “mouth piece” when they are defending a med error “.. a Pharmacist is a professional and would not knowingly do something to harm a patient…”
If you are working in an environment that COULD cause patient harm and you have not express concerns – in writing- then when that major med errors happens – and it will – claiming after the fact that you had concerns… but only expressed them verbally …will do nothing to save your ass.
Jim mentioned Eric Cropp… if he had said something about the work environment .. he may have lost his job… but HE DIDN’T and he ended up losing HIS JOB… HIS LICENSE.. HIS FREEDOM.. convicted of manslaughter.. only to have his employer and the BOP to do an “investigation” and the system was given a “all clear”… only to have the corp’s system have a major overhaul after all the dust had settled.
http://ismp.org/newsletters/acutecare/articles/20091203.asp
IMO… the BOP are going to continue to favor the corp permit holders – because 75% of the BOP’s have chain exec on them and start stiffer penalties on individual RPH’s because of the surplus.. “the system” will never to be found at fault.. but they will “get rid” of those “bad apples”… those RPH’s who cause pt harm.
How rational is it to think that perfection can be achieved from imperfect humans?
OH so true!! When I sold my pharmacy 10 yrs ago my Techs were making $15 per hour!! (on job training) They were worth every penny.
I now work with techs who are lucky to make $10 per hour from big pharma. Most deserve more in my opinion, especially those who learned on the job. Those who got a cerificate ususally suck @ their job & make mine 3 times more work.
I worked with a tech that would constantly say “when I was in pharmacy school…” I gave up correcting him but I do think that he felt his 6 months of tech training was equivalent to my 8 years in college!
http://www.beltonjournal.com/index.php?option=com_content&view=article&id=1129:class-prepares-students-to-become-pharmacy-technicians&catid=35:news&Itemid=429
Class prepares students to become Pharmacy Technicians
Ha Ha Ha!!! Thatis a good link Pharmaciststeve! The class is taught by a registerd nurse and teacher. Oh boy thats a real winner of a class!
Yea, did you know they can add CPhT after their names too? Do these students even know that if you have any reasonable amount of knowledge and the desire to study out of a prep book for a few weeks, you can just take the test and all you need is a 70% to become “certified”? No $15k and 6 months of irrelevance and free labor. I forced myself to learn the brands and generics without the tech school and that ended up in my getting an 80% the first try. I, however, did not know about getting to add CPhT to the end of my name: DAMN!
To reiterate JP, poor suckers.
Sorry for the question but what Plan B second pill are you talking about?
Plan B is a one pill treatment. Maybe you were thinking about Next Choice?
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Matt, it was Next Choice. I used “Plan B” for the patients who visit this site
I find it rather interesting that InstyMed is available in 24 states, and marketed as an aid to physician dispensing. Reading the website information, the concept ‘seems’ as its availability should be in conflict of interest with physicians, the Practice of Pharmacy Act, and the entity that provides the machine.
As a temp filling in at retail shifts, it goes without saying that scripts written by ER doctors are among the most annoying–failing to identify prescribers, prescribing drugs to patients without adequate patient medication or allergy information, and other factors that negate the value of a pharmacist’s judgment and practice. I laughed when I saw that it can instantly adjudicate insurance.
I have to agree with a lot of the above, with a few comments of my own.
I fully agree with keeping medication advice completely the job of the RPh/PharmD- they have the schooling, license, and liability. Some of the pharmacists I work with will ask my opinion on various OTC items, especially vitamins or the new-fangled things that keep coming out (Acai, Goji berry, those million and a half pills Dr. Oz says will make your ass skinny and invincible).
However, I am also a paramedic (meaning I have 18+ months of training solely in immediate and emergent care, as well as 1000 hours of experience that my department requires before letting me make any decisions) on the side, and the pharmacists almost invariably turn over questions about injuries or burns to me. They may recommend a pain reliever, burn/rash cream, or eye drop, but when it comes to anything involving an actual injury/physical issue, they ask me to consult. (Note: in my area, there are a LOT of uninsured people, as well as a lot of undocumented workers, and most of the people work in hard labor, construction, landscaping, and factory/machine work, and our pharmacist is known throughout the city for his 110% helpful, caring attitude, so a LOT of people come to our pharmacy for things like sprained ankles or burns because the hospital is just too expensive).
So, I never, ever give out medication advice to a patient, even when I’ve heard the pharmacist say it a million times (though if they ask me which is better of allegra, zyrtec, or claritin, I’ll sure tell them), because I am not about to lose my job and sure as HELL not going to endanger the livelihood of my beloved pharmacists.
But I am licensed and insured in physical stuff, and my RXM and I decided that it was better that I help them when possible instead of making them shell out non-existent $$$ to go to the hospital or worse, not get treated. In this part of our practice, my RPh never gives out physical advice, because that’s not what he’s licensed to practice.
So, I fully agree that CPhTs are NOT pharmacists and should never act like one.
And damn, having a bad tech in your pharmacy…..homicide/suicide usually seems preferable, honestly. But a good tech is worth their weight in gold….but we rarely make over $11. (And that’s being “senior” with five years of experience….)