Have a complaint about CVS? So do pharmacists: Many just walked out(text.npr.org)
text.npr.org
Have a complaint about CVS? So do pharmacists: Many just walked out
https://text.npr.org/1202365487
77 comments
Aside, thanks for the link specifically to text.npr.org. I hadn't realized they had such a simple frontend and I'll definitely be doing that. And it's a great reminder to support them again.
There are a number of text-only news sites. Aside from NPR, 68k News, CNN, and the Christian Science Monitor:
<https://blog.wturrell.co.uk/text-only-news-websites/>
<https://news.ycombinator.com/item?id=35313232>
<https://blog.wturrell.co.uk/text-only-news-websites/>
<https://news.ycombinator.com/item?id=35313232>
In the past I’ve used a small, local pharmacy and the experience was great. It was fast and - more importantly - I felt like the staff wasn’t miserable.
With the ongoing amphetamine shortage I’ve had to spend a lot of time calling around and seeing who has my medication in stock, then having my doctor send the prescription there. As a result, I’ve seen a lot of pharmacies recently.
CVS and Walgreens both seem like awful places to work (with the obvious caveat that this is drawn from a few very local datapoints). Extremely understaffed, so the staff was harried and had to deal with customers who were often pretty irritable by the time they got to the front of the line (I waited 30 minutes yesterday at Walgreens, 40 minutes at CVS a few months back).
I would have expected the pharmacy at the Super Walmart to be one of the worst in terms of working conditions, but they had a lot of people working, so the line moved pretty fast and no one behind the counter looked anywhere near as harried as the pharmacy techs at Walgreens/CVS.
CVS and Walgreens both seem like awful places to work (with the obvious caveat that this is drawn from a few very local datapoints). Extremely understaffed, so the staff was harried and had to deal with customers who were often pretty irritable by the time they got to the front of the line (I waited 30 minutes yesterday at Walgreens, 40 minutes at CVS a few months back).
I would have expected the pharmacy at the Super Walmart to be one of the worst in terms of working conditions, but they had a lot of people working, so the line moved pretty fast and no one behind the counter looked anywhere near as harried as the pharmacy techs at Walgreens/CVS.
I've experienced one of the CVS stores in question first hand. It's total chaos where your short staff, people at the drive thru, phone is ringing, 8 people standing in line with half of them just rude, med refills never ready on time. This year to compensate they shut down the drive thru, shorten hours, even close up a certain day. It's odd because a CVS 2 miles away is the complete opposite.
Then you'll see the neighborhood whiners show up on toxic Nextdoor to talk about the CVS experience, however many will offer smaller local pharmacies as a solution this past year. It's a well known issue with both CVS and Walgreens. Yet if you visit a Costco pharmacy it's loaded with staff, never a problem. I feel bad for the staff but it's all on CVS to manage better.
The last time I visited a few weeks ago, drive thru was fast at this location so hopefully it stays consistent.
Then you'll see the neighborhood whiners show up on toxic Nextdoor to talk about the CVS experience, however many will offer smaller local pharmacies as a solution this past year. It's a well known issue with both CVS and Walgreens. Yet if you visit a Costco pharmacy it's loaded with staff, never a problem. I feel bad for the staff but it's all on CVS to manage better.
The last time I visited a few weeks ago, drive thru was fast at this location so hopefully it stays consistent.
For non-Americans like me: apparently CVS stands for "Consumer Value Stores," and is a well-known American retail and healthcare company.
It is simply known as "CVS". The name "Consumer Value Stores" is a relic from the very early days of the company that hasn't been used in a very very long time.
It's a deprecated name, like "American Telephone and Telegraph Company".
It's a deprecated name, like "American Telephone and Telegraph Company".
Also note that to a first approximation zero Americans will be able to tell you what "CVS" stands for; I'm not even sure it stands for anything anymore.
"healthcare company" is comically generous.
First time I’ve heard that and that’s probably true for everyone I know as well.
We’ve moved away from them to a pharmacy in a local grocery store. IDK WTF is wrong with CVS, but they always seem to have 4-6 people working but can’t process more than 40 customers an hour, between the window and the line inside. I’ve read comments from people who’ve worked there who claim CVS chronically understaffs the pharmacy, but god, they always seem to have a lot of folks behind the counter, so I guess their processes must be incredibly inefficient.
And if you know for a fact you need to ask someone there a quick question, there is no way to do that over the phone without going through one of the most hostile phone trees I’ve ever experienced. Say, if you need to ask if they’ve got some drug in stock before telling your doctor to send it there (why the everloving fuck customers have to do this seems-like-it-should-be-automated labor themselves is another question—but we do, and CVS makes it about as unpleasant as possible)
And if you know for a fact you need to ask someone there a quick question, there is no way to do that over the phone without going through one of the most hostile phone trees I’ve ever experienced. Say, if you need to ask if they’ve got some drug in stock before telling your doctor to send it there (why the everloving fuck customers have to do this seems-like-it-should-be-automated labor themselves is another question—but we do, and CVS makes it about as unpleasant as possible)
Recently, they switched to outsourcing some kind of tasks normally done by the in-pharmacy staff. Last time I was in there, the 5-6 people were standing around while they "waited for the cloud to catch up".
I swear to god, heavy computerization has been a net-negative in 90% of business cases, and it’s only because it’s been extremely beneficial in the other 10% that we have fooled ourselves into thinking it’s a generally-good idea.
It's a bold statement but I think it would be highly worthy of analysis. For example, while I like that I can search easily for better flights, it seems like the airlines have gamified the entire process, and it feels like just calling a travel agent was much easier way back when, and did not cost more. But is that true? Same goes for customer support ... how maddening is email support and offshore support. Isn't chat support much worse than just calling a human? Has all of this automation really made things holistically better? Is it easier now to be a human than it was in 1980? Or is it actually much worse ... are we living in a technology dystopia?
Right, it's not the computerization, it's the gamification, or to put a name on it - cost accounting. In both the pharmacy and travel examples, the computer workflow was a huge win for everyone until the investors demanded growth every quarter, forever. As soon as society imparts that requirement, the customer becomes the enemy, to be out maneuvered and anything spent on them minimized "at all costs."
"The customer becomes the enemy". Perfect...that's how I feel more and more often these days.
To be fair, Walgreens is way worse than CVS. There has been insane understaffing throughout their stores and it's terrible. They are like labor shortage, but the reality is that their wages have not kept up with inflation and thus they are unable to hire sufficient staff to staff their stores.
I had a nice chat with someone from Walgreens about the horrible wait times and staffing issues which turned into shelving issues when I was picking up a prescription while wearing my union solidarity tshirt.
The long & short is the conversation was that Walgreens management simply had no concept of how to talk with their workers and relations had broken down.
Simply raising salaries would solve most of their problems but the inability of Walgreens to address is likely a symptom of a deeper problem.
The long & short is the conversation was that Walgreens management simply had no concept of how to talk with their workers and relations had broken down.
Simply raising salaries would solve most of their problems but the inability of Walgreens to address is likely a symptom of a deeper problem.
Not a single pharmacy within 10 miles of me has over 2 stars in the reviews. They're impossible to work with, take forever, don't do what they promise, and don't care. I've switched to my insurance carrier's mail order pharmacy and things have been much smoother.
I use amazon pharmacy and I really like it because they disclose all the prices transparently and deliver it with two day prime. Because they disclose the prices, I often pay out of pocket for a 90 day supply of generics, because it’s cheaper than 30 days with insurance.
I use Amazon Pharmacy too and it’s one less thing in my life to worry about.
They take insurance and even when insurance doesn’t cover a drug, the prices are comparable to PBM (think GoodRx) rates. Plus shipping is free and next day and I get 5% back with my Prime Visa. They also work with doctors on the backend to get prescription refills — I don’t have to do anything. I haven’t stood in line at a pharmacy for drugs in years (I still go to my local Safeway pharmacy for vaccines though).
The only downside is if you need your drug same-day, Amazon Pharmacy won’t work for you. But otherwise I’ve found it to be cheaper, and way less hassle than visiting a retail pharmacist.
They take insurance and even when insurance doesn’t cover a drug, the prices are comparable to PBM (think GoodRx) rates. Plus shipping is free and next day and I get 5% back with my Prime Visa. They also work with doctors on the backend to get prescription refills — I don’t have to do anything. I haven’t stood in line at a pharmacy for drugs in years (I still go to my local Safeway pharmacy for vaccines though).
The only downside is if you need your drug same-day, Amazon Pharmacy won’t work for you. But otherwise I’ve found it to be cheaper, and way less hassle than visiting a retail pharmacist.
They refuse to carry my medications :(
All well and good until someone in your family has a prescription that can’t be mailed.
Do regulations require middlemen? Can pharmacists just decide to set up their own shop?
My memory is fuzzy but I think the issue is the negotiations with insurance companies at the drug manufacturers. Somebody might have a better source but from what I remember, even the majority of independent pharmacies are having to operate under cvs.
Edit: for the replies I see to this thread so far, I think they are off the mark. The problem is not running a business. The problem is the way things are setup between the insurance companies and drug manufacturers almost requires cvs to become a middle man. most independents are still at the mercy of cvs.
Edit: for the replies I see to this thread so far, I think they are off the mark. The problem is not running a business. The problem is the way things are setup between the insurance companies and drug manufacturers almost requires cvs to become a middle man. most independents are still at the mercy of cvs.
Source: My partner is a pharmacist with an MBA
The biggest issue to running a pharmacy independently by far is insurances. When you're not big enough to negotiate drug prices with the drug companies, or the payouts with the insurance company you get squeeze out in fast order.
Couple of examples, he worked at <big name grocery store chain with pharmacies> and they averaged a revenue of $3 per script. This managed this because they were able to negotiate prices with both the insurance company and the drug companies. For someone not big enough to negotiate, many drugs will cost the pharmacy more than insurances will reimburse. Another example is billing insurance companies. This grocery store paid 5 cents per insurance bill, and rebills were free. When he worked at an independent pharmacy, it cost them $1.50 to bill insurance, and rebills were not free. Keep in mind, the big company was able to negotiate $3 of revenue per script after negotiating. In almost all cases, an independent pharmacy loses money on the vast majority of their prescriptions.
Largely, independent pharmacies stay afloat by taking on massive debt and doing other value add services. The independent he interned at did warfarin clinics and diabetes stuff (not sure what). It's a passion project for the person owning the pharmacy. Not a profit center.
Insurance companies though, they rake in tons of money.
The biggest issue to running a pharmacy independently by far is insurances. When you're not big enough to negotiate drug prices with the drug companies, or the payouts with the insurance company you get squeeze out in fast order.
Couple of examples, he worked at <big name grocery store chain with pharmacies> and they averaged a revenue of $3 per script. This managed this because they were able to negotiate prices with both the insurance company and the drug companies. For someone not big enough to negotiate, many drugs will cost the pharmacy more than insurances will reimburse. Another example is billing insurance companies. This grocery store paid 5 cents per insurance bill, and rebills were free. When he worked at an independent pharmacy, it cost them $1.50 to bill insurance, and rebills were not free. Keep in mind, the big company was able to negotiate $3 of revenue per script after negotiating. In almost all cases, an independent pharmacy loses money on the vast majority of their prescriptions.
Largely, independent pharmacies stay afloat by taking on massive debt and doing other value add services. The independent he interned at did warfarin clinics and diabetes stuff (not sure what). It's a passion project for the person owning the pharmacy. Not a profit center.
Insurance companies though, they rake in tons of money.
The closing of most independent pharmacies and overall decline of the profession is a huge loss to society.
I recently looked into investing/trying to find a partner to open an independent pharmacy. The idea has always fascinated me and I think there are some cool things you could potentially do.
But even if you ignore all the crazy regulation and compliance stuff (a huge thing!) - you don't even get past the "this business is simply not viable" stage. Independents are being squeezed out - you can't even reliably expect to be paid your cost for a given medication.
It seems like it could be such a nice, low-key, lifestyle sort of business if you find the right area - but I found no effective way to make it even pay for itself, much less turn a profit or be able to attract any investors even looking to find community projects vs. maximizing returns.
Many areas in the US are like this these days. What should be thousands of small little competing shops being eaten up by the oligopoly. Same thing happened/is happening to pretty much all independent physician groups, and is also now happening to dentists. Every single bit of professional autonomy is being slowly eaten away.
At this point you can't even do one as a passion project it seems, unless you are independently wealthy of the sort to be able to operate at a loss indefinitely as some form of charity.
But even if you ignore all the crazy regulation and compliance stuff (a huge thing!) - you don't even get past the "this business is simply not viable" stage. Independents are being squeezed out - you can't even reliably expect to be paid your cost for a given medication.
It seems like it could be such a nice, low-key, lifestyle sort of business if you find the right area - but I found no effective way to make it even pay for itself, much less turn a profit or be able to attract any investors even looking to find community projects vs. maximizing returns.
Many areas in the US are like this these days. What should be thousands of small little competing shops being eaten up by the oligopoly. Same thing happened/is happening to pretty much all independent physician groups, and is also now happening to dentists. Every single bit of professional autonomy is being slowly eaten away.
At this point you can't even do one as a passion project it seems, unless you are independently wealthy of the sort to be able to operate at a loss indefinitely as some form of charity.
Another detail for my Wife who works in insurance billing for some providers is that you have to use a whole stack of tools and processes, often by each insurance company, to make claims and process them. If anything is denied there are a billion weird and wild edge cases that you need to just hunt down and contact companies for.
I'm fascinated by CostPlusDrugs. I can't figure out why they started taking insurance.
I'm fascinated by CostPlusDrugs. I can't figure out why they started taking insurance.
Pharmacy billing is completely different from other medical billing. This is largely not true. The billing is easy, the contracts and getting paid enough are hard.
CVS is responsible for the killing of many local pharmacies across the USA, via Caremark.
Yes, independent pharmacies exist. Most don't do this because it requires knowledge about running a business on top of being a pharmacist. It's the same reason most software developers don't run their own software company, or the same reason most foodservice workers don't run their own restaurant.
A pharmacy can run as a small business and many do, with the appropriate licensure. They typically offer better service than the big chains, to which the big chains respond by leveraging economies of scale to starve out local shops wherever possible.
There are plenty of local pharmacies.
Someone appears to have registered a CVS account using my email address, so several times a week I get their awful spam. And while I could probably block their emails, there doesnt seem to be a way to correct the account email. I'm in Europe so the ccs website isnt even accessible to me. They don't respond to emails, and their US phone number drops me into an endless queue. All in all, seems like yet another scummy company.
My sympathy to any pharmacists, and anyone else, working there.
My sympathy to any pharmacists, and anyone else, working there.
Just route the sender to spam? Do you really put this much work into every spammy sender? Any decent email frontend should fulfill your desire in a single click.
"mark as spam"
Speaking of CVS, they have one very cool feature I haven't seen replicated anywhere else: the price printer machine. Many places have scanners that will show you the price of an item on a screen, but in my experience only CVS has one that actually prints out a physical paper showing the price of the item.
Accordingly, I make a point to print the price of at least one of my items each time I buy from CVS (for morale).
Accordingly, I make a point to print the price of at least one of my items each time I buy from CVS (for morale).
I tried prescription delivery by mail for the first time this year, and it's been phenomenal. No more fighting for parking and waiting in line forever, or forgetting to pick up the prescription in time. It just arrives on a subscription whenever it needs to. It's really nice!
Can’t help but think local delivery is better, even if by mail. This is great until there are no readily available options for urgent fill or refill.
Could they not coexist? I think the same was said about Amazon displacing local businesses (and it has to some degree), but we also still manage to have local retailers.
If my local pharmacist has a delivery by mail program, I'd totally use them.
If my local pharmacist has a delivery by mail program, I'd totally use them.
This was a good prompt to check on the pharmacies available near me. "What pharmacy are you using?" is a normal question during appointment check-in, so I'll change pharmacies at that time.
Is it easy/cheap/reliable to get prescriptions filled/delivered online in the US? Do many people use that option?
Not really.
Two complicating factors - A: latency, when I’m sick, I need antibiotics now, not tomorrow afternoon. B: - It isn’t legal to mail some classes of drugs. These includes, but os not limited to, pain meds, anxiety meds, and sleep meds.
My local CVS was offering free mail delivery for the first year or so during Covid. My experiences were generally good, but I have a couple meds in the unable-to-be mailed category, so I end up having to by there every couple weeks anyway.
Two complicating factors - A: latency, when I’m sick, I need antibiotics now, not tomorrow afternoon. B: - It isn’t legal to mail some classes of drugs. These includes, but os not limited to, pain meds, anxiety meds, and sleep meds.
My local CVS was offering free mail delivery for the first year or so during Covid. My experiences were generally good, but I have a couple meds in the unable-to-be mailed category, so I end up having to by there every couple weeks anyway.
Many ADHD meds, too. Between two very-ADHD kids, we lose tens of hours a year to screwing around with their prescriptions, plus the paid time various professionals lose to it. Some of it’s unavoidable (if you insist on the level of safeguards they apply to these) but a ton of it’s just because the processes are terrible and nobody’s bothered to make them better. One of those hidden costs of our healthcare system.
Last few insurance plan sheets I’ve looked over have also all had higher copays (like 3x higher, iirc) for mailed drugs. Not sure why.
Last few insurance plan sheets I’ve looked over have also all had higher copays (like 3x higher, iirc) for mailed drugs. Not sure why.
Not even legal to ship those classes of drugs to a "manned" (personelled?) pick-up place with mandatory ID verification?
At that point you might as well just go to the pharmacy. The US doesn't have such infrastructure.
Yes, but the personnel who verifies ID has to be a licensed pharmacy technician. And the facility must maintain the legally required audit logs and secure storage for the drugs while they await pickup.
So, where I am: (Sweden)
- Online prescriptions are very cost-effective compared to retail. Typically free next-day delivery. I don't have any hard stats, but my estimate is that at least 50% of prescriptions are filled online.
- Deliveries are typically shipped to the house's/apartment's mailbox or when chosen so or if the package doesn't fit, to the closest pickup place, typically inside a grocery store. When that happens you need to show an ID to pick it up.
- Retail drug stores, particularly in small villages have been forced to raise prices dramatically. Essentially an old-people tax. :( It's not unusual for them to have 2x prices in retail compared to online.
- There is some debate about shipping hard drugs directly to mailboxes. Some want to require those things going to a pickup-place with ID verification. That makes a lot of sense, I think.
- Online prescriptions are very cost-effective compared to retail. Typically free next-day delivery. I don't have any hard stats, but my estimate is that at least 50% of prescriptions are filled online.
- Deliveries are typically shipped to the house's/apartment's mailbox or when chosen so or if the package doesn't fit, to the closest pickup place, typically inside a grocery store. When that happens you need to show an ID to pick it up.
- Retail drug stores, particularly in small villages have been forced to raise prices dramatically. Essentially an old-people tax. :( It's not unusual for them to have 2x prices in retail compared to online.
- There is some debate about shipping hard drugs directly to mailboxes. Some want to require those things going to a pickup-place with ID verification. That makes a lot of sense, I think.
In my experience, it's pretty easy and reasonably cheap. I've used capsule for a few years and it's fine. The downsides are: 1) it can be hard to get prescriptions same day and 2) they don't carry everything I take so I still have one prescription I have to get at a B&M pharmacy.
It’s a bad grocery store and an equally mediocre pharmacy. HEB does both better, faster, and cheaper.
CVS is fine... I just wish their receipts were a few pages shorter.
I don't know anyone who ever holds on to those receipts to use the coupons. If I need to get more than one thing, it just makes me have to buy one thing first and hope one of the coupons will work on the other thing, and it doesn't feel like that's how it's intended to be used. Definitely does not get me to buy more.
My wife bought homeopathic eye drops from CVS (she didn't know what homeopathy was). It burned her eyes. I got a refund and stopped shopping at CVS.
Lots of eye drops cause a burning sensation as an unfortunate side-effect. Especially astringent types.
On the other hand, many FDA-approved drugs are approximately as effective as homeopathy. (Phenylephrine for congestion is the classic example.)
> Phenylephrine for congestion is the classic example
So classic it's brand new news?
So classic it's brand new news?
It's been known to be ineffective for a while, it's just that recently the FDA has admitted it.
I would imagine practically anyone who has tried taking it orally quickly became aware that it was not effective, and it has been available for years. I don't know that I've personally met a single person that found it effective, and the anecdote of having to register into "pre-crime" government databases to get the stuff that actually works is widely shared (in the USA).
It's been known to not do a whole lot for at least a decade, it just took until recently for the FDA to catch up and say "no you can't sell it".
It is effective just not orally
I hear Walgreens is pretty bad, too.
Not whataboutism-- this seems to be universal right now?
Not whataboutism-- this seems to be universal right now?
Universal? Absolutely not.
Example: I had an appointment at a doctor's office in a medical office park. By "medical office park" I'm referring to a plot of land with lots of doctor and specialist offices, which are not part of a single chain, provider, or medical group.
During the appointment, I was told to pick up some over-the-counter medication. I noticed that, in the middle of the medical office park, there was a pharmacy. So, I went over there.
There was a single employee on duty, a pharmacist. I was the only customer there. This was around 11:30, so I expect at least one person was at lunch. Though there was work to do, the pharmacist seemed relaxed, not hurried. They asked what I wanted, found it, asked some questions (to identify possible complications), and handled payment.
Since this pharmacy is in the middle of this office park, I expect they are mainly getting business from the individual medical offices nearby.
Example: I had an appointment at a doctor's office in a medical office park. By "medical office park" I'm referring to a plot of land with lots of doctor and specialist offices, which are not part of a single chain, provider, or medical group.
During the appointment, I was told to pick up some over-the-counter medication. I noticed that, in the middle of the medical office park, there was a pharmacy. So, I went over there.
There was a single employee on duty, a pharmacist. I was the only customer there. This was around 11:30, so I expect at least one person was at lunch. Though there was work to do, the pharmacist seemed relaxed, not hurried. They asked what I wanted, found it, asked some questions (to identify possible complications), and handled payment.
Since this pharmacy is in the middle of this office park, I expect they are mainly getting business from the individual medical offices nearby.
This is my current secret as well. Depends on how dense your area is, but either find a medical office park like this, or a hospital campus if in a major city.
They usually will have a pharmacy that is largely used to service other providers in park/campus, and thus is typically pretty laid back. A large number of these keep a retail counter open almost as an afterthought, but in a hospital setting usually meant for patients being discharged or whatever I imagine.
Most of these will take anyone off the streets. Recently this has started to change so I expect in a few years most will no longer take "retail" (the secret is long out, so more and more control-seekers are wasting staff time) customers at all and only service inpatient.
It's worth driving an extra 10 minutes if you have such an option. Otherwise if you must go chain I've had the best luck and heard mostly good things from staff about Costco. Walmart also seems to have a quite functional pharmacy - but it can be quite hit or miss depending on location, and is starting to suffer from the general overworking conditions the rest of the chains have.
They usually will have a pharmacy that is largely used to service other providers in park/campus, and thus is typically pretty laid back. A large number of these keep a retail counter open almost as an afterthought, but in a hospital setting usually meant for patients being discharged or whatever I imagine.
Most of these will take anyone off the streets. Recently this has started to change so I expect in a few years most will no longer take "retail" (the secret is long out, so more and more control-seekers are wasting staff time) customers at all and only service inpatient.
It's worth driving an extra 10 minutes if you have such an option. Otherwise if you must go chain I've had the best luck and heard mostly good things from staff about Costco. Walmart also seems to have a quite functional pharmacy - but it can be quite hit or miss depending on location, and is starting to suffer from the general overworking conditions the rest of the chains have.
It's the same work environment at any high-volume low-margin retail workplace.
Most retail positions don’t require a doctoral degree.
I don't care who you are, or where you're from, or what you did, as long as you're selling things for pennies of profit in high volume to the general public, you're going to be busy and overworked.
The difference is pharmacists have more leverage. Replacing a cashier is trivial. Replacing a licensed pharmacist isn’t.
The lack of difference is that the functional result appears to be the same based on observation.
[deleted]
It's only universal at the large chains. I started using an independent pharmacy because the local CVS was obviously overworked / understaffed.
I’d love to use an indie pharmacy, but my employers pharmacy benefit provider is…. CVS. If I don’t get most of my drugs filled there, they cost 2-3x as much, sometimes more.
Walgreens seems to have an incredibly inefficient processing operation. Each prescription fill requires someone to access several different computers. A vaccination took an hour, of which 90% was paperwork.
I thought Subversion was the answer to complaints about CVS? Then git followed afterwards.
/s
/s
if a CVS competitor comes along and names the chain subversion, then i for one will be shopping there
It wasn't just the volume of customers and prescriptions to fill - she specifically cited the automated loudspeaker messages of "call waiting" that occur several times per minute all day as people phone in with questions.