Life has a funny way of just… happening. One and a half years go by after becoming a registered pharmacist, my motivation to go back to medical school was dwindling, even though frustration with my different jobs was growing. It helped that I had also recently read Robert Kiyosaki’s book, Rich Dad, Poor Dad. Although I don’t agree with everything he has to say, I do find myself agreeing with him more often than not. For a couple years I let fear win; I didn’t want to take a risk and change the situation I was in.
So let’s talk about some of the different pharmacist jobs that I had. My first job as a pharmacist was in retail pharmacy. Since I worked as a pharmacy intern during pharmacy school for a major retail pharmacy chain, I signed on to stay at the store where I had trained.
It seemed like a good situation: I would become the new partner for the pharmacist in charge (PIC), and we’d alternate working Wed-Fri and Sun-Tue then be off for an entire week (Wed-Tue), essentially never having to work on a Saturday! Granted the shifts would be 14 hours long.
However, to quote Thanos from Avengers: Infinity War, “reality is often disappointing.” A few short months after I started, another store in the chain needed “fixing” and corporate moved my PIC to that store. They told me that I had been there long enough (one year as an intern and a few months as a licensed pharmacist) to run the pharmacy.
As the new PIC, one thing I quickly noticed was how many prescriptions for controlled substances seemed suspicious. In retrospect it made complete sense; this was during the time when “pill mills” were on the rise in Florida.
I began calling more often to confirm prescriptions for controlled substances, often finding them to be illegitimate or the provider would tell me not to fill because they were unaware of the patient shopping around at other dentists’ or physicians’ offices. Soon the suspicious crowd began filling their prescriptions at neighboring pharmacies. I stopped seeing the cash paying, brand name only (eg. OxyContin) customers.
Eventually corporate noticed that we went from filling 6,000 prescriptions per month to only 5,800 per month. Our monthly gross revenue took a hit and I had to explain myself to the district supervisor. I told him about the illegal activity that I was discovering and reporting to the Sheriff’s Office. I’ll never forget his response… “Don’t ask questions; just fill it.”
I knew it was time for me to leave that job and we mutually parted ways. Fortunately for me, the hospital was where I did most of my clinical rotations in pharmacy school was hiring. I probably got the job because my project on pharmacokinetics played a role in updating their pharmacy dosing service in which pharmacists could manage specific drugs with a narrow therapeutic index.
The first year was great: I liked my coworkers, pharmacy leadership was wonderful in creating a culture of camaraderie, and I was able to get involved with my alma mater to precept pharmacy students and intermittently give lectures on pharmacokinetics. I still had quite a bit of free time and, with my wife still in pharmacy school, I picked up a side job as a consultant pharmacist for nursing homes to support her and try to pay off my student loans faster.
The next year was very unsettling. The pharmacy director retired and his replacement and I did not see eye-to-eye. This taught me about the fragility and importance of work culture and environment, and how even a “dream” job can become a nightmare.
With new resident physicians coming and going annually as well as new attending physicians, we pharmacists were constantly having to prove ourselves and justify our value; this became exhausting. One of the worst things I saw in the workplace was just how territorial and petty people can be; instead of helping each other move forward professionally (and ultimately helping patients), people were keeping each other down.
And what about the consultant pharmacist job? These elderly patients had multiple providers (PCP plus specialists) that seemed to never communicate. Most of my time was spent cleaning up duplicate (classes of) medications. It seemed like a never ending spiral of “take this med for that complaint” and “take this med to treat the side effect of the other med.”
No matter the pharmacist job, I felt like my independence and creativity were being stifled. So many things could be more proactive in the grand scheme of patient care. Back then I knew I wasn’t savvy enough in business and finance to be my own boss, but I could change my role on the healthcare team [without having to legislate my way there].
Can anyone else relate? Please comment below and share your own stories.