12 Behind-the-Scenes Secrets of Pharmacists

Though they often toil in retail settings next to candy bars and magazine racks, pharmacists are fully accredited medical professionals who process, check, and consult on the roughly 4.3 billion prescriptions physicians write every year.

To find out more about life behind the apothecary counter, mental_floss spoke with a few of the men and women in the nifty white smocks about frustrating quotas, illegible handwriting, and why you might see a little mayonnaise smeared on your pill bottle.  

1. THEY STOP DOCTORS FROM KILLING YOU.

Jason—he prefers not to reveal his last name—has been a retail pharmacist in the Midwest for more than 20 years. When he hears complaints about slow service from patients who think of the chain stores as glorified drive-throughs for prescriptions, he sighs.

“It’s not just putting pills in a bottle,” he says. “With a prescription, there’s a good likelihood of there being wrong information. We catch interactions that could kill you.” On an average day, Jason might see 200 orders. He estimates 10 to 15 percent contain errors in quantity, instructions, or dosing that need to be corrected by phoning the physician.

2. THEY USUALLY HAVE ABOUT 15 MINUTES TO ACCOMPLISH THAT.

Owing to the volume of prescriptions processed by major chains like CVS and Walgreens, the one or two staff pharmacists on the clock have precious little time to spare. While pharmacy technicians can count pills and perform other tasks, only the pharmacist can double-check a medication is accurate before it’s turned over. “We have a time limit,” says Aaron, a retail pharmacist in Texas. “Reports get printed out at the end of the week and we get reprimanded for not meeting metrics. People ask if there’s anything they need to know about their medication. Yes, lots, but I only have a few seconds to give you the highlights.”

3. DECIPHERING A DOCTOR’S HANDWRITING IS LIKE CRACKING A CODE.

One course not taught in pharmacy school: how to decipher the frenzied scribbling of your neighborhood physician. “You’re expected to learn it on the job,” Jason says. “You learn traits. Some doctors don’t learn any Roman numeral besides ‘I,’ so 11 of them means '11.' It’s like a puzzle.” Sometimes Jason will phone the doctor’s office to crack the secret of a handwriting habit. “The funny thing is, you can move 10 minutes away to another side of town and have to learn a whole new set of patterns.”

4. THEY OFTEN DON’T GET A LUNCH BREAK.

After graduating pharmacy school, Megan spent a little over a year at a retail pharmacy counter. “It was pretty much the worst year of my life,” she says, citing the fast-food pace of the job as a deterrent to continuing. How fast? Orders typically come in so quickly that pharmacists don’t take a lunch break. They have to eat portable meals or snacks while standing. “You don’t really get any breaks unless you take it upon yourself. Labor laws don’t apply. Employers aren’t saying we can’t, but when you’re in the weeds, it’s hard to make it actually happen.”

5. THEY HAVE FLU SHOT QUOTAS.

While it’s no secret pharmacies love to promote flu shots, the even harder sell is happening behind the scenes. “When [chains] found out they could get reimbursed by Medicare and make $15 a shot, it went from, ‘Let’s offer it,’ to becoming mandatory," Jason says. "Baby on the way? Get a flu shot. On the subway a lot? Get a flu shot.” Pharmacists who fall below parity risk having a percentage of their annual bonus taken away.

6. THEY WISH YOU’D STOP HANDING THEM DIRTY PRESCRIPTIONS.

Like sweaty money coming from a sock, prescriptions of vague origin can be repulsive to the person who has to handle them. “People hand you paper that looks like it’s been through a garbage disposal and act like it’s no problem,” Megan says. As a courtesy, try to avoid spilling food, water, or blood on your prescription. (She’s seen them all.)

7. THEY HATE ELECTRONIC PRESCRIPTIONS.

According to Jason, they don’t reduce errors—they just make them more legible. “There are over 200 systems in my state alone,” he says. With no continuity, “There’s a real disconnect.” Doctors don’t always understand the drop-down menu—advising patients to take a cream “one tablet daily,” for example—and patients think their medication will be ready in seconds. It won’t. “Imagine 100 people in your office sending you an email at once, then coming in and asking, ‘Did you read it yet?’”

8. DEFINITELY READ THE PAMPHLET. (JUST DON’T LET IT SCARE YOU.)

Many consumers have adopted a management system for the drug information document that typically gets stapled to every prescription bag: They toss it in the garbage. This is not wise. “I stress for patients to read it,” Aaron says, citing time constraints at the pharmacy. But he also cautions not to let the list of possible side effects scare you. “The side effects aren’t listed by how often they occurred in a clinical trial. 1 percent is different from 10 percent. You might see ‘psychosis’ and not know it happened in point-five percent of patients.”

9. THEY SOMETIMES DROP PILLS ON THE FLOOR. THEN YOU EAT THEM.

“It’s not supposed to happen,” Megan says. “The counting trays have a lip, but stuff still falls on the floor. Then it’s considered an adulterated drug and people aren’t supposed to put it back in the bottle, but it happens anyway.”

10. THEY KEEP NOTES ON YOUR BEHAVIOR.

Most pharmacy software has a prompt that lets pharmacists and technicians make a note when a customer is behaving oddly or is otherwise circumspect. “Some people have the same issue every month,” Aaron says. “They get a narcotic and insist we miscounted and gave them 10 fewer pills than prescribed, even if it was a sealed bottle.” Push your luck—one man got so irate having to wait at a drive-through he began filming on his phone, which is a privacy violation—and you can find yourself banned.

11. YOU’LL BE SEEING MORE OF THEM IN HOSPITALS.

Megan left retail to become a hospital pharmacist. “The last year of pharmacy school, you’re rounding with a medical team at a hospital,” she says. “To have all that knowledge in the wheelhouse and go to a fast-food type environment, I didn’t like it. I want to use those clinical skills. We go into a room and visit with a patient and can manage drug regimens." 

12. THEY TECHNICALLY DON’T NEED A PRESCRIPTION TO HELP YOU.

Not on an official prescription pad, anyway. “A pad is just a guide, with space for names and birth dates,” Jason says. “A doctor can technically write something down on a napkin and we have to honor it.” They will, however, still call the office to verify.

All images courtesy of iStock.