12 Behind-the-Scenes Secrets of Pharmacists

IStock
IStock

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.

Looking to Downsize? You Can Buy a 5-Room DIY Cabin on Amazon for Less Than $33,000

Five rooms of one's own.
Five rooms of one's own.
Allwood/Amazon

If you’ve already mastered DIY houses for birds and dogs, maybe it’s time you built one for yourself.

As Simplemost reports, there are a number of house kits that you can order on Amazon, and the Allwood Avalon Cabin Kit is one of the quaintest—and, at $32,990, most affordable—options. The 540-square-foot structure has enough space for a kitchen, a bathroom, a bedroom, and a sitting room—and there’s an additional 218-square-foot loft with the potential to be the coziest reading nook of all time.

You can opt for three larger rooms if you're willing to skip the kitchen and bathroom.Allwood/Amazon

The construction process might not be a great idea for someone who’s never picked up a hammer, but you don’t need an architectural degree to tackle it. Step-by-step instructions and all materials are included, so it’s a little like a high-level IKEA project. According to the Amazon listing, it takes two adults about a week to complete. Since the Nordic wood walls are reinforced with steel rods, the house can withstand winds up to 120 mph, and you can pay an extra $1000 to upgrade from double-glass windows and doors to triple-glass for added fortification.

Sadly, the cool ceiling lamp is not included.Allwood/Amazon

Though everything you need for the shell of the house comes in the kit, you will need to purchase whatever goes inside it: toilet, shower, sink, stove, insulation, and all other furnishings. You can also customize the blueprint to fit your own plans for the space; maybe, for example, you’re going to use the house as a small event venue, and you’d rather have two or three large, airy rooms and no kitchen or bedroom.

Intrigued? Find out more here.

[h/t Simplemost]

This article contains affiliate links to products selected by our editors. Mental Floss may receive a commission for purchases made through these links.

10 Secrets of Epidemiologists

Epidemiologists are fans of charts.
Epidemiologists are fans of charts.
metamorworks/iStock via Getty Images

Unless you know an epidemiologist or are one yourself, those “disease detectives” might not have occupied a very large portion of your brain. Last year, that is. Now, with the coronavirus pandemic at the top of mind—and at the top of so many headlines—there’s a good chance you’re at least aware that epidemiologists study diseases.

To be more specific, the Centers for Disease Control and Prevention (CDC) defines epidemiology as “the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.” So what exactly does this mean? Mental Floss spoke with a few epidemiologists to shed light on what they do, how they do it, and which germ-friendly foods they avoid at the buffet.

1. People often mistake epidemiologists for skin doctors.

Since the word epidemiologist sounds like it might have something to do with epidermis (the outer layer of skin), people often think epidemiology is some offshoot of dermatology. At least, until the coronavirus pandemic.

“Prior to that, no one knew what I did. Everyone was like ‘Oh you’re an epidemiologist—do you work with skin?’” Sarah Perramant, an epidemiologist at the Passaic County Department of Health Services in New Jersey, tells Mental Floss. “I would be rich if I had a dollar for every time I got asked if I work with dermatologists.”

2. Epidemiologists don’t discover a new disease every day.

Though some epidemiologists do look for unknown diseases—certain zoonotic epidemiologists, for example, surveil wildlife for animal pathogens that might jump to humans—most are dealing with diseases that we’re already familiar with. So what do they do every day? It varies … a lot.

Epidemiologists who work at academic or research institutions undertake research projects that help determine how a disease spreads, which behaviors put you at risk for it, and other unknowns about anything from common colds to cancer. But it’s not just about devising experiments and studying patient data.

“I like to tell my friends and family that my job is about four different jobs in one,” Dr. Lauren McCullough, an assistant professor in the department of epidemiology at Emory University’s Rollins School of Public Health, tells Mental Floss.

Writing, she says, is “the most important part.” It includes requesting grants, devising lectures and assignments, grading her students’ work, writing about her research, and more. She also sits on admissions committees, reviews other epidemiologists’ studies, and oversees the many people—project managers, data analysts, technicians, trainees, etc.—working on her own research projects.

Those who work in the public health sphere are often monitoring local outbreaks of diseases like the flu, Lyme disease, salmonellosis, measles, and more. If you test positive for a nationally notifiable disease (any of about 120 diseases that could cause a public health issue), the CDC or your state health department sends your electronic lab report to the epidemiologist in your area, who’s responsible for contacting you, finding out how you got sick, and telling local officials what steps to take in order to prevent it from causing an outbreak.

3. Epidemiologists have to make some uncomfortable phone calls.

At least the person on the other end can't see your expression of consternation.Andrea Piacquadio, Pexels

Epidemiologists sometimes have to ask pretty personal questions about drug use and sexual activity when trying to figure out how someone got infected, and not everyone is happy to answer them. “I’ve gotten hung up on many a time,” Dr. Krys Johnson, an assistant professor in Temple University’s department of epidemiology and biostatistics, tells Mental Floss.

Some simply aren’t willing to accept that they might have been exposed to a disease without knowing it. After several employees at a certain company tested positive for COVID-19, for example, Perramant started calling the rest of the workers to tell them to go into quarantine; this way, she could prevent sick people who weren't yet showing symptoms from spreading the disease without knowing it. But not everybody was open to her advice. “They would just swear up and down, ‘I haven’t been in touch with anybody who’s positive, please don’t call me again,’” Perramant says.

But there are plenty of cooperative people, too, especially victims of foodborne or diarrheal illnesses. “They really want to know where they got sick because they’re so miserable that they never, ever want to deal with that again,” Johnson explains. Parents of sick kids are also generally forthcoming, since they want to keep their kids healthy in the future. And then there are those who don’t have any problem spilling their secrets to a stranger.

“There was one woman who was very memorable,” Johnson says. “I called her about her Hepatitis C, and she was like, ‘Oh, honey, I did drugs back in the ’80s. That’s where I got my Hepatitis C. I pop positive every time!’”

4. Epidemiologists deal with a lot of rejection.

Public health epidemiologists have to learn to just shrug off all the rude tones and dial tones, and epidemiologists in academic settings need thick skin for different reasons.

“There’s just a lot of rejection,” McCullough says. “‘That idea isn’t good enough; this paper isn’t good enough; you’re not good enough.’ That is just a resounding thing. There’s a high bar for science; there’s a high bar for federal funding; and it takes a lot to cross that bar. So in the academic setting at these top-tier institutions, you really just have to have a thick skin.”

5. Just because epidemiologists' guidelines change doesn't mean they're wrong.

Sometimes, McCullough explains, the story of a disease can change over the course of one study. When you look at the first 100 people in a 10,000-person study, you’ll see one story emerge. By the time you’ve seen 1000 people, that story looks different. And after you’ve seen the data from all 10,000 people, the original story might not be accurate at all.

Usually, epidemiologists can complete the whole study of a disease and draw conclusions without the world clamoring for half-baked answers. But with a brand-new, highly infectious disease like COVID-19, epidemiologists don’t have that luxury. As they’ve learned more about how the pathogens spread, how long they can survive on surfaces, and other factors, they’ve changed their recommendations for safety precautions. Everyone else in the world of epidemiology expected this to happen, but the general public did not.

“If we say something this week that contradicts what we said last week, it’s not that we were wrong,” Johnson says. “It’s that we learned something between those two time points.”

6. Being an epidemiologist would be easier if people kept better track of their behavior.

Often, people omit vital information about how they got exposed to an illness because they just don’t remember all the details. You could easily recall devouring a few slices of the decadent chocolate cake your mom baked for your birthday last Friday, but you might not be able to name every bite of food you ate on a random Thursday three weeks ago.

“People aren’t telling us the whole truth, but it’s not that they’re being intentionally obtuse,” Johnson explains. “With recall bias, unless there’s a reason for us to really remember, we’re not going to remember everything we actually ate.”

This has made it especially difficult to trace an aerosolized disease like COVID-19.

“All my friends going into the Fourth of July were like, ‘Should we have a get-together?’” Perramant says. “And I said, ‘You can have people over, but you better take an attendance list. You better have a little spreadsheet on Google Drive that has every person’s name and their phone number, so that when one person tests positive and gets sick this week, when I call you, you will be able to give me that information like that.’”

7. Epidemiologists have reason to be wary of buffets, cruise ships, mayonnaise, and cubed ham.

It's all fun and games until someone eats warm egg salad.Tim Meyer, Unsplash

Infectious disease epidemiologists may have accepted that germs are a part of life, but they also know where those germs like to congregate.

“I don’t go to buffets, I have never been on a cruise ship and I don’t intend to, I’m super conscientious when I fly,” Johnson says. “And I’m really aware of whenever mayonnaise-based things are put out at family functions. If you’re ever at a potluck and people come down sick, the first thing people say [they ate] is potato salad or egg salad, because mayonnaise can spoil so quickly.”

“[Cubed ham] is one particular microbe’s very favorite thing to multiply on, so if you’re gonna have ham, make it a whole ham,” she says.

8. Teaching people is a really rewarding part of being an epidemiologist.

In addition to actually leading lectures in the classroom, academic epidemiologists also work extremely closely with their students on research projects; McCullough estimates that she’s in contact with hers at least once a day when they’re collaborating on a study.

“To work with someone so closely, and to watch them progress as a scientist and as a person, and then to have to let them go and send them out into the world, I find that very rewarding,” McCullough says of her trainees. “As a scientist in an academic institution, there’s not a whole lot of immediate gratification. Our papers get rejected, our grants don’t get funded, but the trainees are always a source of immediate gratification for me, so I hold them close to my heart.”

Epidemiologists in other spheres have teaching opportunities, too. When a community experiences a disease outbreak, public health epidemiologists like Perramant are responsible for helping the general public understand what they can do to prevent the spread.

“I like to teach kids about infectious disease and infection prevention for what’s relevant to them. We’ve had a couple of large outbreaks at summer camps, and last summer I put together a training for camp counselors,” Perramant says. “That’s always a part of my job that I really love.”

9. Epidemiologists have a unique understanding of racial disparities.

At this point, it's exceptionally clear that COVID-19 is disproportionately affecting people of color in the U.S. They're more likely to be exposed to it, they have less access to testing, and the preexisting conditions that place them at a higher risk can be the result of systemic racism. When these trends started to become apparent, McCullough got flooded with phone calls asking why. Her answer? This isn’t new. As she’s seen in her work as a breast cancer researcher, Black women are more likely to die of that disease than their white counterparts, and similar health disparities exist across the board.

McCullough explains that the general public is finally realizing what epidemiologists already knew: That poor disease outcomes in minority, low-income, and rural populations aren’t because of anything those people are doing on an individual level. Instead, it’s a result of systemic issues that keep them from leading financially comfortable, healthy lifestyles with access to healthcare and other resources.

“It’s not just COVID—it’s almost every single chronic and infection ailment that’s out there,” McCullough explains. “So this is a real opportunity for people to step back and take an assessment of where we are in terms of our healthcare system, and what we’re doing so that everybody has equitable outcomes. Because people shouldn’t die just because they live in a rural area, or just because they’re poor, or just because they’re Black or Hispanic.”

10. They've had to deal with a lot of “armchair epidemiologists” lately.

Until this year, epidemiologists had to suffer through people mistaking them for dermatologists. Now, during the coronavirus pandemic, people finally know at least a little about their jobs. In fact, people are so confident in their newfound epidemiological knowledge that many are fancying themselves experts on the subject.

“At the beginning of 2020, there were like 500 epidemiologists, and now there are about 5 million. Everybody thinks they’re an epidemiologist,” McCullough says. “There’s a science to it, and it’s a science that requires training. We went to school for a really long time to be doctorally trained epidemiologists.”

It’s not just about advanced degrees, either. Beyond that, you need years of firsthand experience to grasp all the nuances of understanding methods, interpreting data, translating your findings into recommendations for the general public, and so much more. In short, you can’t just decide you’re an epidemiologist.

Perramant has her own analogy for the recent influx of self-proclaimed epidemiologists: “It’s like armchair psychology. Poolside epidemiology now is a thing.”