Our job as pharmacists is to dispense the right medication to the right patient and make sure it is correct and appropriate. It's also our job to protect the patient, sometimes from the prescriber or doctor who wrote the prescription.
Above is an example. A careless pharmacist would just type this up as:
Dissolve one and one-half tablet under tongue twice daily as needed for pain.
But a good pharmacist would see the conflicting notes and if he or she didn't know the patient and history, he or she would call the doctor. This careless doctor actually wants the patient to take one tablet in the morning and one-half tablet in the pm.
What would happen if this patient was given incorrect instructions? Probably not much. But with a different drug this could be catastrophic.
Think about that the next time you're pressuring your pharmacist to hurry with your prescription.
In the United States, on average there are four billion prescriptions filled every year. (See LINK).
That's a lot of prescriptions.
But the average patient has no idea what's involved at the pharmacy. People only see the pharmacy from the outside, much like we only see my son's head poking out from the sand in the picture... and have no idea that there's so much involved in the filling of their prescription.
When you drop off your prescription, first it is typed into the computer. If you're new to the pharmacy, we have to get all your personal information first, including your pharmacy prescription insurance. Most of the time this is fairly smooth, but at least 10-15% of people have no idea their prescription coverage might be different from their health coverage.
Sometimes we have to call your prescription insurance to get the billing information. This is odd -- it's YOUR insurance, not ours. If you didn't have your Visa card with you, we wouldn't call Visa for this information, right? So that can add time to the process.
Next we make sure the medication is correct. We check the dosage, instructions, and quantity. We make sure your medication doesn't interfere with any of your other medications or allergies.
If it does, we may call the doctor to get it resolved or find a way to tell you how to manage it. All of this takes time. You'd be surprised how many doctors write for medications that you're allergic to or conflict with something else you're taking even though you told the doctor.
We make sure we fill your medication with the correct medication. This is where a lot of pharmacists take heat in the media when a mistake is made, but in actuality, this rarely happens. I read a figure that pharmacists are 99.98% accurate when filling. That sounds great, but it's not 100% which we all strive for. Suppose your local neighborhood pharmacy fills 50,000 prescriptions a year. That calculates to 10 mistakes a year. That's less than one mistake a month.
Most of those mistakes are something completely harmless or caught before it ever gets to the patient. But there's always one or two prescriptions that are ingested before the error is discovered. Fortunately most of those situations are harmless too.
We always do our best. We're always 100% focused on our job and there's a lot of checks and balances in the process to stay accurate, but it is not perfect. Mistakes do happen.
But YOU can help. The next time you drop off a prescription at the window, remember... you're only seeing the head of a boy buried in sand. There's a lot that goes on behind the scenes. Demanding that we hurry never helps the situation and increases our likelihood of error and nobody wants that.
Mr Dispenser published his book, Pills, Thrills, and Methadone Spills: The Adventures of a Community Pharmacist in 2013.
From the forward on page 8:
"This compilation provides an insight into the small thrills we experience every day. The joy of being able to drink a hot beverage; the thrill of being rude to customers without their realizing it."
"This book will be a joy to all who read it. It is a useful guide for new pharmacists about to embark on their careers: these are the things you will be faced with on a daily basis. It is a wonderful read for those of us who have been around for a while -- a time to reflect and reminisce."
And without a doubt these statements are true. Now for you folks in the colonies, i.e., Americans, you must be forewarned that this book is written by a Brit. They speak English, but not American English. Some things you have to translate into American meanings. For example, what we call a "floater" pharmacist in the USA is referred to as a "locum." (French for a "person who temporarily fulfills the duties of another.") Once you get that part down then the laughs continue. Some of the medications Mr Dispenser refers to have different names in the USA too. There is a glossary in the back to help with some of the terms. The differences in terminology should not deter Americans or anyone else from buying this book. If anything, it just goes to show all pharmacists everywhere that we all endure the same adventures even in different backgrounds and cultures.
My favorite part of the book is entitled, "If Pharmacy was a Game Show" -- except Mr Dispenser left out what might make the best pharmacy game show. It would be something based on a Japanese game show and the dispenser would be forced to cut off a finger for dispensing the wrong medication.
What's also fun about the book is that it is not just musings by Mr Dispenser. You will recognize many pharmacy people from Twitter -- people you're probably already following and/or follow you. That makes it more fun because you know the "minds" behind the @ symbol.
In preparation for this book review, I interviewed Mr Dispenser and asked him a few questions:
What got you interested in writing about pharmacy? Why the book?
I have a pharmacist for five years. I started blogging first after three years. It started serious but soon descended into mirth. My books are a collation of my blogs, other peoples blogs and anecdotes from Facebook and Twitter.
What has been the greatest challenge to writing and publishing a book?
The greatest challenge to writing the book was editing which took up most of my time. Publishing was relatively straight forward as I did it myself on Amazon.
Does the company you work for know you are writing about pharmacy? Are they supportive?
The company I work for are aware of the books. I wouldn't say that they are supportive but they haven't sacked me yet!
What do you see ahead in the world of pharmacy?
I see the next few years to be dark as long as we continue in the global recession. There is an excess of pharmacists in the UK too. Things will get better though.
How did you come up with the title?
I asked people on twitter to give me suggestions of the title. A lovely lady called Helen Root came up with the title 'Pills, Thrills and Spills'. I added the word Methadone for impact.
Pills, Thrills, and Methadone Spills: The Adventures of a Community Pharmacist is available on Amazon.com. I must warn you that the author does lie on the cover page of the book. Mr Dispenser says "may" cause laughter. That's a lie. This book WILL cause laughter. There -- you've been warned.
Check this LINK to buy the book. It has a list price of $3.99 on Kindle and $6.99 in paperback for a new copy. Also, 5% of sales are going to the Pharmacist Support Charity. Apparently there is a used copy for sale for $999.11 so if you have plenty of money to blow, go for that one.
And when you're done with the first book, check out Mr Dispenser's second book: Pills, Thrills, and Methadone Spills: Techs, Drugs & Birth Control. Using more contributions of social media, Mr Dispenser continues with the laughs!
