So whats it like to work in a US pharmacy?

I've just finished my first month of work and what have I discovered that's worth sharing with you? Well, not that much really. The bottom line is that the core function of pharmacy is in essence still the same, namely prescriptions come in, a pharmacist gives a cognitive perusal over the possible clinical correctness of the medication and checks that the drug, label and name, etc are correct, and the medication is handed out to the patient with the option of a consultation should it be wanted. I imagine this process is more-or-less the same worldwide. However, there are vast, enormous, gigantic differences when it comes to the specifics. Firstly, their are various differences with the systems with respect to the physical processes. I can only compare between the US and the UK, but in the UK the process is simple - one person takes the prescription in, hands it to the pharmacist or dispenser, the pharmacist signs it off, and someone hands it out. There is usually only one computer in each UK pharmacy. In the majority of US pharmacies they divide the system in to four processes. An "in window" takes the Rx in, they process it and the Rx is filed and the rest of the system runs on the electronic Rx. The virtual Rx then goes to the "filling window" where another tech, clerk, intern or pharmacist produces a label, scans a bar code on the side of a bottle of tablets, and puts the label on the bottle. The meds are then passed to the "Quality Assurance" window, which is always run by a pharmacist, who signs it off and bags it, and finally, when the patient collects it, the drugs are given out at the "out window". This process has a certain logic to it, and doesn't take long to get used to, but it is very very different to how things are generally carried out in the UK! Also, the US uses almost 100% of its drugs from bulk packs, where in the UK almost 100% is now supplied from 28-day calendar packs. And of course the National Health Service in the UK has no equal in America, where either cash is king or insurance companies are involved. This adds a whole layer of difficulty to the procedure whereby at the in-window the patient hangs around whilst the clerk enters their details and applies electronically to their insurer for authorization of payment. Once that is confirmed then the patient can go, knowing they are OK to collect their medication with either an agreed co-pay (small cost towards the drugs) or no-payment if their insurance is that comprehensive, or a large sum of money if they have crappy or no insurance. Clearly very different from how things are done in the UK. Amongst the other things I have now learnt, and worth mentioning are: 1. Payment is weekly! And by cheque (sorry, by check!). You can set up a direct bank payment (they call that auto-debit), but initially you work one week in arrears and get a check the next Friday - very nice. 2. In California at least, you do have to do a certain amount of hours in a hospital setting. I shall have to work out exactly how to organize that later, but I should be able to volunteer myself in a local hospital pharmacy for a few weekends, and get the required hours done. 3. If you have money, bring it. If you have family, leave them at home! Life is super-expensive here, and it is easy to blow a fortune in no time. Be warned! 4. There is no formal, organized assistance to pass the two remaining exams, viz the NABPLEX and the State Law Exam. You will have to work on that yourself (other companies may help their interns, nut my one doesn't!). So talk to the pharmacists and find out what you need to start studying, and get down to it. 5. For me, the company health insurance kicks in after 6 months. Given the price of drugs, if you are on any kind of medication - BRING 6 MONTHS OF IT WITH YOU! 6. About 50% of the drugs have different names here, and another 25% I've never heard of or come across before. So for all good being a pharmacist in the UK for the last 16 years has given me, I am only familiar with about 25% of the dispensary now! I have a lot of work to do! I have got three books to learn from, and aim to do just a little bit of studying every couple of days, as I have 9 months to learn it all in - and I can't afford to get it wrong. So for once in my life I actually have to put some effort in to this. I will give more details about my studying later. OK, that's about it for now. There's probably a load of stuff I've forgotten so I may add another entry to put it all in, or may just sneakily edit this entry later, but for now, I am just thankful that I have made it this far, and am loving the feeling of working in an American dispensary, as I have aimed for this for such a long time. Good luck to all of you, it can be done! Farmacyst