Wikipedia:Reference desk/Archives/Miscellaneous/2015 December 19

= December 19 =

Detective Sergeant or Sergeant Detective
A character in Rizzoli and Isles has the rank of "Sergeant Detective" in the Boston PD. I've never heard of this formulation before. Here in the UK a sergeant in the CID would be called a "Detective Sergeant". I've checked some other American police articles (LAPD, NYPD, SFPD, LVMPD), and either they don't have a separate detective rank structure at all, or they have detectives, but higher ranks revert to the plain "sergeant", "lieutenant" denomination. Is the BPD unique in this respect? Which title would more Americans recognise? Rojomoke (talk) 11:06, 19 December 2015 (UTC)
 * "Detective Sergeant" gets 502,000 hits on Google; "Sergeant Detective" gets 35,600. Google counting is not often a useful metric, but when the numbers are this far apart, it probably means something. Police rank doesn't seem to mention either formulation for either the US or UK. And, unfortunately, Police ranks of the United States doesn't have the same kind of graph that Police ranks of the United Kingdom does. I'm Canadian, not American, but the D-S formulation sounds more familiar to me, though I can't say that I've heard either combination enough to really have a preference. 99.235.223.170 (talk) 17:52, 19 December 2015 (UTC)


 * Sergeant is an adjective meaning "servant" and given its Norman origins, its pre- or post-nominal position is irrelevant in that sense. That is, either way it means assistant detective, in the way that attourney general means "general attorney". μηδείς (talk) 02:41, 20 December 2015 (UTC)
 * A little googling found detective sergeant, sergeant detective, sergeant: detective and detective/sergeant in the U.S. So probably no standard name. Rmhermen (talk) 02:59, 20 December 2015 (UTC)


 * From my vast experience watching film noir and such, I've come across a fair number of detective sergeants, e.g. Joe Friday, but this is the first time I've heard of a sergeant detective. It sounds so wrong. Clarityfiend (talk) 03:24, 20 December 2015 (UTC)


 * In any case, "Sergeant Detective" is indeed the correct rank in Boston. See pages 1-2 of this PDF from the official Boston Police Department web site. --76.69.45.64 (talk) 05:05, 20 December 2015 (UTC)

US pharmacies
Are there any that just sell unopened prescription meds from the manufacturer, rather than opening them up, pouring (hopefully the correct) pills into their own bottle, hopefully in the correct quantity, and slapping their own (hopefully correct) label on them ? One limitation would seem to be that prescriptions must then be in quantities that can be arrived at by adding quantities the manufacturer provides. StuRat (talk) 16:03, 19 December 2015 (UTC)


 * Talk to your pharmacist. I certainly get the occasional unopened package when the medicine is sold in a standardized dose and the pharmacy doesn't carry the medicine in bulk amounts.  It's unlikely they are going to get you expensive little packages of items they get in bulk.  But we can't predict what they will be willing to do.  I once [about a decade ago] complained at the high price for benadryl from a family owned pharmacy, so the owner sold me a wholesale bottle of 1000 25mg capsules for $16.00 rather than repackaging 30 and selling them for $2.49 a bottle. μηδείς (talk) 18:05, 19 December 2015 (UTC)


 * I'm surprised to hear that this still happens in the US. In my UK experience, for many years prescription medicines have invariably been dispensed in blister packs, sometimes with each blister helpfully labelled with the day on which its pill is to be taken. (The same usually applies to non-prescription items such as Paracetamol and Ibuprofen.) AndrewWTaylor (talk) 14:01, 20 December 2015 (UTC)


 * Almost all of my drugs come repackaged from large wholesale containers into smaller general individualized childproof containers with the pharmacy's name on them. (I deal with the second largest US chain; I haven't been to a privately owned pharmacy since last decade.)  Almost the only time this does not happen is with newer patent medicines like Jardiance and Zithromax where a manufacturer's bottle or blister-pack contains either exactly one month's prescription or an entire course as in the case of an antibiotic.


 * But most of the other drugs I take (Metformin, Levothyroxine are no longer patented, and are sold to the pharmacies in bulk and repackaged. On the rare occasion I will get elixirs that come in a pint size bottle from the manufacturer which are not then re-bottled, but then they will often say something like 33- or 100-day supply, rather than the normal 30 or 90.


 * I am not sure what Stu's underlying concern is, but I have on occasion been offered different packaging options, or told the dispenser that rather than have her wast a bottle on 100ml of a 473ml prescription I'll wait till the order comes in on Tuesday next. This really is a case where talking directly to the horse might be best. μηδείς (talk) 18:45, 20 December 2015 (UTC)


 * I have multiple concerns about the US system:


 * 1) More potential for theft this way. My dad had some of his EPO stolen every time he got a batch.  (The pharmacist was quietly fired, but not charged, so is likely doing the same thing elsewhere now.)


 * 2) More potential for mistakes this way.


 * 3) More potential for poisoning/adulteration that way. Not so much the pharmacy, but say a homicidal spouse who can more easily mess with pills in the little amber bottle than those in a commercial blister pack.


 * 4) The pharmacists never seem to bother putting "indications" on the label, only something like "Take one, as needed". An elderly person taking many meds may not remember: "Now is this one my heart palpitation med or for pain ?"


 * 5) It's rather slow. You can't usually walk up to a pharmacist, give him your prescription, and immediately get your prescription.  Instead you have to call ahead or wait once there, for all that pill shuffling to occur.  (I took my Mom to the pharmacy straight from the doctor who issued a prescription, and there was no line, but she still had to wait over an hour as there were other prescriptions to fill before hers.)


 * 6) I have to think the US system increases price. Using highly paid pharmacists to shuffle pills around rather than having a machine in a factory do it has to figure into the final price.  As for the quantity discount mentioned previously, I'm not sure how significant that really is, since the packaging and per unit cost of meds is typically mere pennies, with most of the cost being amortization of the research and development costs.


 * 7) Expired meds. Can we really trust pharmacists to toss out that bottle of 1000 expired pills, at great cost, rather than giving them to the patient with an altered expiration date ?


 * 8) Contamination. The pharmacist might well cough on your pills.  If your med happens to be an immunosuppressant, this is a particular concern.  Of course, contamination may also occur at the factory, but the pharmacist contributes an additional risk, beyond this.


 * One argument I have heard in support of pharmacists is that they check for and warn about potential drug interactions, but that doesn't require any pill shuffling, they can just slap an additional label on the commercial package (the commercial packages might want to add some white space, so pharmacists can do this without again hiding the manufacturer's info and warnings). StuRat (talk) 19:08, 20 December 2015 (UTC)


 * Another point about our blister packs is that they always (I think by law) come with a Patient information leaflet, which would allay some of these concerns. As to point (5), it's still never the case that I can "walk up to a pharmacist, give him your prescription, and immediately get your prescription" - it always seems to take at least 15 minutes, and often more, presumably in part because of some bureaucratic procedures that have to be performed. AndrewWTaylor (talk) 21:10, 20 December 2015 (UTC)


 * For my meds (I am bipolar), I generally very often get a mixed box of meds of different brands, but all of the same strength, in a generic white box, with a clear warning that they are mixed up. The pharmacy never has enough of the one brand. The 15 minute wait time is taken up by looking for them and putting them all together, as well as dealing with other prescriptions. KägeTorä - (影虎)  ( もしもし！ ) 23:57, 20 December 2015 (UTC)


 * I wonder why they keep buying different brands. Maybe some of their customers insist on each brand ? StuRat (talk) 21:52, 21 December 2015 (UTC)


 * The bottom line based on your numbered points, Stu, is that negligence an malice are always a possible issue when dealing with others, as well as our own fallibility. Nothing you've mentioned couldn't also be a problem with a host of industries, like automotive repair and food preparation.  Given you are aware of certain issues, obviously that's half the battle.


 * As for your numbered issues, 1 & 2 are simply dealt with by counting the pills upon purchase. When I get controlled substances from the chain store they always have two people's initials on the number.  Dealing with a chain probably addresses 7 as well, since they will have a high enough turn around that it's much more likely something will be out of stock than sitting on the shelf for years.


 * Again, talk to your doctor, who can specify that you be prescribed a brand name if available, and to your pharmacy and ask if you can get the scrip filled in the original packaging. We can't do that advocacy for you here. 17:09, 21 December 2015 (UTC)


 * Counting pills and examining each to verify that it's the correct type certainly isn't something you can do at the pharmacy. If you do it at home, getting them to believe you found an error and make it right seems unlikely.


 * As for other industries, many have changed from custom-preparing items for the customer to just handing them one created in a factory. Once upon a time, clothing shops had bolts of fabric, took your measurements, and then had clothes made to order, at great cost.  Now, however, your average clothing shop won't have anyone on staff making the clothes.  (The higher end shops might allow you to tailor the clothes there, but the equivalent at a pharmacy would be to give you customized drug interaction info based on the other meds you are taking.)


 * Or consider if you bought a cell phone, and instead of being sealed in the original packaging, it came in a bag that said "Honest Ed's Cell Phones !". I sure would be suspicious of that.


 * I thought of another problem with the current US system:


 * 9) Counterfeit meds are difficult to detect, by the consumer, without seeing the original packaging materials. StuRat (talk) 21:37, 21 December 2015 (UTC)