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12 Behind-the-Scenes Secrets of Pharmacists

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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.

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Why You Might Not Want to Order Tea or Coffee On Your Next Flight
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A cup of tea or coffee at 40,000 feet may sound like a great way to give yourself an extra energy boost during a tiring trip, but it might be healthier to nap away your fatigue—or at least wait until hitting ground to indulge in a caffeine fix. Because, in addition to being tepid and watery, plane brew could be teeming with germs and other harmful life forms, according to Business Insider.

Multiple studies and investigations have taken a closer look at airplane tap water, and the results aren’t pretty—or appetizing. In 2002, The Wall Street Journal conducted a study that looked at water samples taken from 14 different flights from 10 different airlines. Reporters discovered “a long list of microscopic life you don’t want to drink, from Salmonella and Staphylococcus to tiny insect eggs," they wrote.

And they added, "Worse, contamination was the rule, not the exception: Almost all of the bacteria levels were tens, sometimes hundreds, of times above U.S. government limits."

A 2004 study by the U.S. Environmental Protection Agency (EPA) found that water supplies on 15 percent of 327 national and international commercial aircrafts were contaminated to varying degrees [PDF]. This all led up to the 2011 Aircraft Drinking Water Rule, an EPA initiative to make airlines clean up. But in 2013, an NBC investigation found that at least one out of every 10 commercial U.S. airplanes still had issues with water contamination.

Find out how airplane water gets so gross, and why turning water into coffee or tea isn’t enough to kill residual germs by watching Business Insider’s video below.

[h/t Business Insider]

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science
Scientists May Have Found the Real Cause of Dyslexia—And a Way to Treat It
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Dyslexia is often described as trying to read letters as they jump around the page. Because of its connections to reading difficulties and trouble in school, the condition is often blamed on the brain. But according to a new study published in Proceedings of the Royal Society B, the so-called learning disability may actually start in the eyes.

As The Guardian reports, a team of French scientists say they've discovered a key physiological difference between the eyes of those with dyslexia and those without it. Our eyes have tiny light-receptor cells called rods and cones. The center of a region called the fovea is dominated by cones, which are also responsible for color perception.

Just as most of us have a dominant hand, most have a dominant eye too, which has more neural connections to the brain. The study of 60 people, divided evenly between those with dyslexia and those without, found that in the eyes of non-dyslexic people, the arrangement of the cones is asymmetrical: The dominant eye has a round, cone-free hole, while the other eye has an unevenly shaped hole. However, in people with dyslexia, both eyes have the same round hole. So when they're looking at something in front of them, such as a page in a book, their eyes perceive exact mirror images, which end up fighting for visual domination in the brain. This could explain why it's sometimes impossible for a dyslexic person to distinguish a "b" from a "d" or an "E" from a "3".

These results challenge previous research that connects dyslexia to cognitive abilities. In a study published earlier this year, people with the condition were found to have a harder time remembering musical notes, faces, and spoken words. In light of the new findings, it's unclear whether this is at the root of dyslexia or if growing up with vision-related reading difficulties affects brain plasticity.

If dyslexia does come down to some misarranged light-receptors in the eye, diagnosing the disorder could be as simple as giving an eye exam. The explanation could also make it easy to treat without invasive surgery. In the study, the authors describe using an LED lamp that blinks faster than the human eye can perceive to "cancel out" one of the mirror images perceived by dyslexic readers, leaving only one true image. The volunteers who read with it called it a "magic lamp." The researchers hope to further experiment with it to see see if it's a viable treatment option for the millions of people living with dyslexia.

[h/t The Guardian]

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