The Role of a Pharmacy Technician

I think the biggest, most important thing that a pharmacy tech needs to remember is the scope of their job. They are the right hand of the pharmacist. First and foremost they need to remember that they are a PART of a unit. They are important and a pharmacist's job would be significantly harder without them, but you should never get so cocky or foolish as to begin doing the job of a pharmacist. 

Counseling a Patient

Counseling the patient is the pharmacist's job, as required by law. I know as much as the next guy how irritating it is to get a question that you know the answer to, but have to say "Let me get you the pharmacist", but that's our job. A good rule of thumb is yes or no. If you're asked a question that has a distinct yes or no answer, you're probably safe. "Is ibuprofen the same as Motrin." "Will this cream work on my rash." Brand-generics are usually a safe bet... That kind of stuff. Any time you find yourself thinking "Well that depends...", it's time to get the pharmacist. And when in doubt, always... ALWAYS err on the side of over-cautious. Definite no-nos: 

1. Use of a medication - lots of medications have multiple indications. If a patient asks you "what's this pill for" the answer is "let me get you the pharmacist". 
2. Side effects of a medication - every medication has side effects. Many of them have interactions which can worsen these side effects. It's the pharmacist's job to make sure the patient understands these, not yours. 

Assisting the Pharmacist

I know sometimes it sucks, especially when you feel like you know more than your pharmacist, but your job as defined by federal law is always inferior to a pharmacist. I heard of an incident recently where a few techs decided not to bother the pharmacist while he was eating lunch and "checked" the prescription without him. Luckily, there weren't any mistakes that time. It's important to remember that not only is this wrong, it's illegal. The pharmacist is legally required to check every prescription that leaves the pharmacy. The pharmacist also goes through years of schooling to know and understand drug interactions and the risks associated with each medication. A technician, at best, has a certification and while they are more knowledgeable than the average patient about the medications, they haven't gone to school for that.

Actually Filling the Prescription
Most of the prescription filling is actually done by the techs. It's your job to be the first to check the scripts for inaccuracy or shenanigans. Yes, people forge prescriptions. People go to multiple doctors. And you're the first line of defense against catching these. As much as knowing how to calculate out the DEA number is important, a lot of forgeries are made from copying (in a multitude of ways) preexisting prescriptions and the DEA number is just copied over from a legitimate script. For reference, calculating the DEA number is simple... (1st, 3rd, 5th numbers) + 2x(2nd, 4th and 6th numbers). The final digit of that number will give you the 7th digit of the DEA number. The first letter of a prescriber's DEA number is usually A or B (but not always and this is often not the case for pharmacies and the like) and the second is almost always the first letter of the last name. If this isn't the case, it's often with female doctors who haven't changed their DEA number when their last name changed (as with a marriage or divorce).

You should be the first to notice when there is an error in the prescription. There are a lot of things to look for in a script...

• Missing quantity
• Known patient allergy to a medication
• Known drug interaction (catching these is often facilitated by the pharmacy's prescription filling software and interaction warnings should never be ignored)
• Prescription too old
• Prescription post-dated (where allowable by law)
• Duplicate therapy (there was once a patient taking multiple -statins because the tech failed to notice the duplicate therapy)
• Incorrect dosage (non-existent strengths, extremely high or low doses)
• Drug-food interactions (which the tech can help the patient avoid by placing the right auxiliary labels)

It seems like a lot to keep in mind, but if you keep it in your mind all of the time, eventually it becomes second nature. 

The Odds and Ends

Finally, as a pharmacy technician you get some of the weirdest jobs in the pharmacy. In smaller pharmacies this can include everything from taking out the trash and sweeping the floors to a little compounding. (I know this sounds silly, but remember to wash your hands after you take out the trash.) Calling the insurance companies about issues usually falls on us... Calling doctors about prior authorizations, calling patients about issues... that's all us. Never forget to be professional and courteous and, especially with the insurance companies, remember that the problem is very rarely ever the fault of the person on the other end of the phone and they're trying just as hard as you to fix the issue with the resources they're given. Never stop fighting for the patient when there's reason. Obviously you don't need to jump through hoops to get a junkie his fill early, but know when to fight. Don't be rude to doctor's offices. Believe it or not, they'll remember. They refer more business to their favorite pharmacies than you realize, so always try your hardest to be polite to them.. leave the yelling at the doctor's office to the patient.

I feel like more of these little reminders come up every day and I'm sure you can expect more of these little notes from me. Look for them under the tag "Duties of a Tech".

Until next time,
C. Samuels