Placement #1 - Boots Pharmacy

Last week was my first pharmacy rotation, or "placement" as they are called here. I worked at a Boots pharmacy in Twerton, a small community a bit south and west of the city centre. Boots is the British equivalent of Walgreens or CVS in the States...however, this particular pharmacy was previously independent, only recently came under Boots ownership, and has managed to retain a lot of the "independent" feel. At this point, it's difficult to use my experiences to compare pharmacy in Britain versus the US, because I don't know what is store-specific rather than practice-specific. But here are some of my observations nonetheless...for those of you who may actually be interested in nerdy pharmacy stuff!

- Everything is much more standardized here (because of the NHS)...for example, all prescriptions are written on the same paper, regardless of the doctor's office.

- The majority of drugs come in "calendar packs" of 28, and doctors actually write for the correct amount. Thus, minimal counting is required.

- If you DO need to count out of a stock bottle, the counting trays are triangular and I have yet to come across a spatula. I still have not figured out the appropriate technique for using this device...

- We dispense massive quantities of bendroflumathiazide and almost no hydrochlorothiazide. Same goes for zopiclone versus zolpidem. And I didn't once dispense Vicodin.

- Pharmacists dispense and supervise methadone for heroin detox. So, about 25 times a day, recovering addicts come in to the pharmacy and the pharmacist measures out the prescribed dose of methadone, then pours it into a plastic cup. He hands the cup of green liquid to the patient, says "Cheers!", and watches him/her down it. Repeat tomorrow. Bizarre.

- Most people do not pay for prescriptions. For the few who do, each script costs 7.20, regardless of item or quantity.

All in all, I had a great experience. The people were really nice to me and hilariously British. I got to do a lot of different things, from order entry to dispensing, filling dossette boxes to administering methadone, and even walking down the street to a patient's home to measure his legs for compression stockings. I was impressed by the services they offered, although again I still don't know if those are services offered throughout the UK, or just in small community pharmacies. I'm looking forward to my next placement at an independent pharmacy in the city centre, which I suspect will be quite different!