It’s 8:30AM , lights just turned on and the counter shutter remains closed. Computers are booted up and the first Pharmacy Technician (PT) punches in. Shortly after, the pharmacy manager walks in, grabs their lab coat and begins checking the schedule. The pharmacist usually comes in a bit later
The counter shutter remains closed and the PT starts the inventory process. All prescriptions that remain open are checked and unfilled prescriptions are logged. A few minutes into the day, the next PT walks in, punches in, and begins to check the medications ordered from the manufacturer the previous day, examining cost, quantity, any DEA information required, and shipping dates. Five minutes to 9, the counter shutter is raised and the first customer is already waiting.
The First Customer
Typically frustrated and a little impatient, the first customer awaits the opening of the counter shutter with eagerness. They step forward, hands their prescription to the PT, mutters some incoherent complaint, and waits for their prescription to be received. The PT asks the customer for their name, date of birth, address, and insurance information. An ID was then requested. After a quick verification, the PT instructs that their medication will be ready for pick-up in one hour (this is a typical turn around time for most popular prescriptions). First to come customers are usually in a hurry, typically on their way to work and are already late as it is. The second, third, and fourth patients are usually a mild variation of the first.
Filling the Prescription
This first customer was new to this pharmacy and had to have all their profile information entered into the system before the prescription order verification process began. The PT entered all the necessary demographic information, followed by the prescription information and then initiated the verification process. The patient’s medical record, issuing doctor, diagnosis, prescription utilization, insurance coverage, and prescribed dosage are all verified by the PT, typically by contacting the issuing physician’s office. The prescription is pushed through inventory and prescription labels are generated. After the labels are generated, the PT heads to the medication stock and searches the pharmacy racks. Hundreds of bottles, boxes, containers, all neatly organized and alphabetized.
After a few hours into the day and the process repeats a few times, the workload begins to pile up. The pharmacy is located in one of the busiest parts of town and becomes a revolving door of customers coming in to fill their prescriptions. Grabbing medication to fill the orders gives a mild reprieve from the movement of the front counter, where customers are being attended to, phones are being answered, and questions are being asked. It’s shocking sometimes how poorly educated the public is regarding pharmaceuticals. Very few customers ask about the effects, uses, or alternatives of the medications they are being prescribed, and are often unsure whether the pharmacist has the answer or that only their doctor can provide the answers to their questions regarding they prescribed treatment. Questions are mainly about cheaper options and discounts.
Once the medication is retrieved from inventory, the filling process begins and, if necessary, compounding procedures. We happen to also be one of the few compounding pharmacies in the city apart from a full-service retail pharmacy. Oftentimes its patients with allergic reactions to certain ingredients found in commercial medications that require the service. Once the proper dosage and count are attained, the prescription is filled according to the prescribed order, it is time to have the boss sign off.
The Pharmacist
There are two people in charge at the pharmacy: the pharmacy manager and the pharmacist. The pharmacy manager goes by dealing with her administrative tasks, ensuring inventory is well kept, orders are correctly placed, shipments have arrived, payments have been correctly made, while the pharmacist attends to the patients and the PTs. Once the prescriptions are filled, it is up to the pharmacist to approve the fill, requiring her to sign off on every order. She spends most of her time on the phone, speaking to patients and physicians about medications. She has the patience to deal with even the most difficult of customers demanding unapproved refills, medications they believe they should have been given instead of what was actually given, and many more issues that you can encounter in such a busy place. The PTs lighten the load, but it is of no way all-encompassing, but they do their best, and she surely appreciates it.
The PT hands her the recently filled prescription, she takes a look at the label, opens the bottle, shakes it around a bit, nods and signs the document.
Pick-Up
As soon as the pharmacist signs off, the PT places the filled prescription in the corresponding bin for customer pick-up. Typically in alphabetical order, all approved prescriptions are placed in their bins to facilitate the pick-up process. Simultaneously one of the other PTs is calling the customer letting them know their medication is ready. The customer usually wants to pick up their medications and be out as quick as possible, rarely asking questions. Some are embarrassed, some are in a hurry, and some are just not having a good day. The PT hands over the medication and kindly asks, “do you have any questions regarding your prescription?” The usual answer is “No, thank you.” You have those who are filled with questions. Some of the typical questions received by customers are “can I drink with these?” or “do I have to take this with food?”, the former being the most amusing. It’s incredible to see the sheer volume of customers, with drop-off equaling the pick-ups, constantly moving. It is almost as if the personnel have eight arms handling sixteen different tasks, but the efficiency being exercised gives the entire process such a graceful flow.
End of Day
As the day begins to wind down and the inflow of customers starts to dissipate, the techs begin their End-of-Day routine. As the last customer comes in and picks up their prescription, the pharmacy manager closes the counter shutter. They all breath in and appreciate the silence that has been absent all day long. One technician heads to the back and begins the inventory process, while the other starts refilling the supplies that will be needed for the next day. It’s astonishing how many pill bottles must be replenished every day.
Once inventory is checked, new orders for low-inventory medications are placed for next day delivery. End-of-Day reports are initiated, starting with controlled substances dispensed followed by new prescriptions and refills. Pharmacist checks off, lab coats are removed then hung, computers are shut down, and, finally, lights off. Home, sweet home.