to be annoyed with the pharmacist assistant?

[holibobs]

I went to get my usual medication from the pharmacy. It's not a medication I'm happy to take and is a personal issue. Got to the counter to collect it and the pharmacist assistant loudly said the name of the medication, opened it up, showed me the tablets (in a busy shop - about 10 people queuing) and said 'are they working for you?'. I was utterly gobsmacked. AIBU to think she should have been discrete?

[3asAbird]

The other month dident feel quite right.

went to co-op to gte cheap preg test.

co-op chemist.

I picked up 2.99 one.

but someone had stocked up shelf wrong.
she says 4.99 i was like thats wrong price.

then she shouts over the room to her supervisor the preg tests in wrong place can she void it off till whilst queue started to form.

Was very cross.


thankfully no preggers.

but made mental note dont go back there.

[candycoatedwaterdrops]

WTF is a 'manageress'?? Sexist bullshit.

[PeppiNephrine]

Please stop bumping zombie chemist threads for your possibly libellous ranting.

[StayAwayFromTheEdge]

Comfy - pharmacy funding is incredibly complicated and not easy to explain. Simply put we get paid for the drugs at cost at a set tariff (no mark up and there never was) plus a fee for dispensing. Since our new contract in 2005 our fees and allowances have been gradually reduced so most pharmacies now have less income than they did before - some of this can be clawed back by providing advanced and enhanced services.

Looking at MURs there are approximately 15 million people living with long term conditions in England and 13300 pharmacies. That gives each pharmacy on average 1100 patients who could benefit from an MUR. Obviously population demographics plays a part and there will be less need in for example the leafy suburbs of Surrey compared to inner city Salford.

The town I work in has 73 pharmacies and and a gap in life expectancy of 13.5 years between the rich and the poor - there is no shortage of patients only time.

Pharmacies also provide a whole range of services which are commissioned according to local need and attract additional payments. These could include:

• stop smoking
  
• drug services
  
• Morning after pill
  
• minor ailments
  
• chlamydia screening

[holibobs]

Thanks Sage - I'm glad someone else understands the circumstances behind taking HRT when still young. Every time I see the nurse to get the prescription she always asks why I'm on it. It pisses me off! I don't like talking about it all. Isn't it enough that I had to go through all this while in my 20s? Isn't it enough that I can't have children? I know they are only interested (can see it in their faces when they ask!) but I hate, hate, hate it!

[cumfy]

Cumfy - most pharmacies will have enough patients with significant medication issues to reach 400

I live in a city of 500,000.

Google lists way over 150 pharmacies in the city. (Way over but I checked the first 150 looked kosher).

So if they all did 400 MURs that would be 60,000/year in a pop of 500,000. 12%.

At a wild guess, I would expect to find an incidence of less than 1% of the pop fitting the profile you describe for MUR.

So, I'm not sure it's obvious that pharmacies, on average, will be seeing 400.

Sorry I'm not trying to pick on you; I'm just genuinely curious about how this all works.

[Fakebook]

Meh. I doubt anyone knows names of HRT medicines off the top of their head. If they'd said something like Methadone and then asked you if it was working, that would have been something to get angry about.

I don't know which poster wrote they only buy pregnancy tests and haemorrhoid cream online: why? What's embarrassing about that?

[olivertheoctopus]

Since when is is anything to do with the pharmacist's assistant whether the drug is working for you or not? That's an issue for you and the prescribing dr. YANBU.

[cumfy]

You do realise that that GPs get paid for providing services don't you?

Yes, and maybe I'm looking at this rather naively, but I had assumed that prior to the MUR arrangements the way that pharmacies made money (from prescriptions) was by putting a mark up on all the prescribed drugs.

Maybe the government has taken away some money with one hand and given it back in the form of MUR, but basically I had no clue that there were any NHS "service" payments per se of any type to pharmacies.

Hence, I naively concluded this seemed like ~£10k pure profit for pharmacies.

Please enlighten me! :o

[StayAwayFromTheEdge]

Cumfy - most pharmacies will have enough patients with significant medication issues to reach 400 - the main issue is finding the time to do them. The outcomes speak for themselves.

One of the criteria for an MUR is that the patient must be taking more than one medicine - so a patient who is only taking HRT wouldn't be eligible.

You do realise that that GPs get paid for providing services don't you?

[EnglishEponine]

Don't want to go too much into the pharmacy's-role part of the conversation just wanted to add my tale of woe, having once been asked veeery loudly by the counter assistant, with several customers within easy earshot, whether my doctor had said anything to me about my particular combination of migraine prophylaxis and antidepressants being taken with the oral contraceptive pill

I was bloody fuming. Back then I was too meek to point out the obvious flaws but if that happened now I would be, let's say, somewhat vocal with my objection

[MayTheOddsBeEverInYourFavour]

YANBU

a bit of discretion is not too much to ask for

I'm on a lot of strong painkillers and so the pharmacists are usually very thorough ( which I appreciate) but there was one time when one shouted out a list of my meds from the other end of the counter and because of that I was almost mugged for my bag of drugs thank goodness my massive DH arrived in the nick of time or it could have been really nasty

Hopefully your email will mean the person involved gets a reminder on the importance of confidentiality

[cumfy]

StayAway, unfortunately I think a lot of pharmacies will see it like that.

At £25 a patient, that's £10k/year straight on the bottom line of the business.

Any chain with 100+ pharmacies will be looking at £1M/year.

I really would be surprised if there is not significant exploitation of this arrangement.

[SageYourResoluteOracle]

Just want to put my tuppence worth in here.

I think there are some very astute and reasonable responses given by pharmacists.

Holibobs- I've been on HRT since I was 31. I hate using it as often when I have to collect a repeat or go for a review with my GP (who really doesn't understand POF/ premature menopause) I have to go in to lengthy explanations as to why I'm on it. It makes me feel 'different' because I know full well it's unusual for someone my age to be taking it. I feel your pain at the lack of discretion you experienced.

[MamaMumra]

Thanks heebie - I think hospital pharmacists get a lot more respect and recognition for what they do compared to community pharmacists. You are absolutely right in what you say. It sounds like this pharmacy is part of a large chain, so the assistant should know that discretion is key.

Talking of robots, have you heard of the ATM like dispensing machines? collects p45

[StayAwayFromTheEdge]

I am a Pharmacist; every time I give out a prescription I ask the patient if they have had it before and if they have any problems with their medication that they would like to discuss.

If it is an acute medication - Antibiotic, pain relief etc I will go through the instructions and warn of any common side-effects.

It a patient has warfarin - I will check there yellow card.

If a patient has methtrexate - I will check that bloods are being done regularly.

Etc, etc

It is what is is expected of us and what we are trained to do. Of course we must also respect the patients confidentiality.

A particular problem with HRT is that several companies make what is in effect the same product; for example if you are prescribed estradiol tablets there is a option of Elleste, Climaval, Progynova or Zumenon - Most patients prefer to stick with one brand, so we usually check with the patient.

Cumfy - there is no target of 400 MURs - That is the maximum number we are expected to do and are usually targeted towards respiratory patients, those taking high-risk meds and recent hospital discharges.

[cumfy]

An MUR (Medication review) requires signed patient consent

The thing is that pharmacies seem to have targets (400/year), so maybe she was testing the water, before proceeding.
I can imagine that most people wouldn't think the pharmacist is the person to discuss this with.

[Heebiejeebie]

I'm a hospital consultant and I rely heavily on my pharmacy colleagues to advise and basically cover my ass. The OP's experience sounds a bit shit, but honestly you're all better off with a qualified person double checking. If the health service is further degraded and you are given the choice between a silent, speedy robot pumping out a box of pills or a person talking to you and making sure you've got the right medication, please, please choose the qualified professional.

[MamaMumra]

Oops pmed you before I read your last few posts

[ShadowStorm]

YANBU to think that the pharmacy assistant should have been more discreet when talking to you about your medication.

[hotbot]

I love pharmacists
, sensible knowledgable, extremely helpful, saving lots of my time and the g.p.s time. First port of call for me is a pharmacist for advice,

[jellybelly18]

Well said pharmacist

[Pharmacistonanamechange]

Sirzy - if someone wanted to be malicious and say they were never asked then, yes, it would be difficult to conclusively prove otherwise. However it is part of standard questioning and training at our pharmacy which we monitor and check continuously, so that should be enough to prove on the balance of probabilities that it was sold correctly. Where it is difficult is when someone is determined to purchase something and they lie to obtain it...
Fortunately for me, in that instance, the responsibility is their own, because if someone says they are on no other medication when they are - there is nothing I can do. I have to trust the information given to me.

[Sirzy]

Good post pharmacist. A GP once prescribed the wrong type of inhaler to DS and I was thankful that the pharmacist noticed, and sorted it with the GP rather than leaving me with an inhaler a 3 year old wouldn't be able to take simply because it is what has been prescribed.


On the having to ask for pharmacy only medicines - how could it be proved someone has been asked? Surely if someone was that way inclined they could deny having been asked even if they had been?