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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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Man Buys Two Metric Tons of LEGO Bricks; Sorts Them Via Machine Learning
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iStock // Ekaterina Minaeva

Jacques Mattheij made a small, but awesome, mistake. He went on eBay one evening and bid on a bunch of bulk LEGO brick auctions, then went to sleep. Upon waking, he discovered that he was the high bidder on many, and was now the proud owner of two tons of LEGO bricks. (This is about 4400 pounds.) He wrote, "[L]esson 1: if you win almost all bids you are bidding too high."

Mattheij had noticed that bulk, unsorted bricks sell for something like €10/kilogram, whereas sets are roughly €40/kg and rare parts go for up to €100/kg. Much of the value of the bricks is in their sorting. If he could reduce the entropy of these bins of unsorted bricks, he could make a tidy profit. While many people do this work by hand, the problem is enormous—just the kind of challenge for a computer. Mattheij writes:

There are 38000+ shapes and there are 100+ possible shades of color (you can roughly tell how old someone is by asking them what lego colors they remember from their youth).

In the following months, Mattheij built a proof-of-concept sorting system using, of course, LEGO. He broke the problem down into a series of sub-problems (including "feeding LEGO reliably from a hopper is surprisingly hard," one of those facts of nature that will stymie even the best system design). After tinkering with the prototype at length, he expanded the system to a surprisingly complex system of conveyer belts (powered by a home treadmill), various pieces of cabinetry, and "copious quantities of crazy glue."

Here's a video showing the current system running at low speed:

The key part of the system was running the bricks past a camera paired with a computer running a neural net-based image classifier. That allows the computer (when sufficiently trained on brick images) to recognize bricks and thus categorize them by color, shape, or other parameters. Remember that as bricks pass by, they can be in any orientation, can be dirty, can even be stuck to other pieces. So having a flexible software system is key to recognizing—in a fraction of a second—what a given brick is, in order to sort it out. When a match is found, a jet of compressed air pops the piece off the conveyer belt and into a waiting bin.

After much experimentation, Mattheij rewrote the software (several times in fact) to accomplish a variety of basic tasks. At its core, the system takes images from a webcam and feeds them to a neural network to do the classification. Of course, the neural net needs to be "trained" by showing it lots of images, and telling it what those images represent. Mattheij's breakthrough was allowing the machine to effectively train itself, with guidance: Running pieces through allows the system to take its own photos, make a guess, and build on that guess. As long as Mattheij corrects the incorrect guesses, he ends up with a decent (and self-reinforcing) corpus of training data. As the machine continues running, it can rack up more training, allowing it to recognize a broad variety of pieces on the fly.

Here's another video, focusing on how the pieces move on conveyer belts (running at slow speed so puny humans can follow). You can also see the air jets in action:

In an email interview, Mattheij told Mental Floss that the system currently sorts LEGO bricks into more than 50 categories. It can also be run in a color-sorting mode to bin the parts across 12 color groups. (Thus at present you'd likely do a two-pass sort on the bricks: once for shape, then a separate pass for color.) He continues to refine the system, with a focus on making its recognition abilities faster. At some point down the line, he plans to make the software portion open source. You're on your own as far as building conveyer belts, bins, and so forth.

Check out Mattheij's writeup in two parts for more information. It starts with an overview of the story, followed up with a deep dive on the software. He's also tweeting about the project (among other things). And if you look around a bit, you'll find bulk LEGO brick auctions online—it's definitely a thing!

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Here's How to Change Your Name on Facebook
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Whether you want to change your legal name, adopt a new nickname, or simply reinvent your online persona, it's helpful to know the process of resetting your name on Facebook. The social media site isn't a fan of fake accounts, and as a result changing your name is a little more complicated than updating your profile picture or relationship status. Luckily, Daily Dot laid out the steps.

Start by going to the blue bar at the top of the page in desktop view and clicking the down arrow to the far right. From here, go to Settings. This should take you to the General Account Settings page. Find your name as it appears on your profile and click the Edit link to the right of it. Now, you can input your preferred first and last name, and if you’d like, your middle name.

The steps are similar in Facebook mobile. To find Settings, tap the More option in the bottom right corner. Go to Account Settings, then General, then hit your name to change it.

Whatever you type should adhere to Facebook's guidelines, which prohibit symbols, numbers, unusual capitalization, and honorifics like Mr., Ms., and Dr. Before landing on a name, make sure you’re ready to commit to it: Facebook won’t let you update it again for 60 days. If you aren’t happy with these restrictions, adding a secondary name or a name pronunciation might better suit your needs. You can do this by going to the Details About You heading under the About page of your profile.

[h/t Daily Dot]

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