Saturday, September 20, 2014

The Magic of TV Advertising

"I need Claritin-D," she said. "I understand you keep that behind the counter."

"Which one did you want?" I ask.

"I don't know," she replied. 

Then HOW do you know you really need it? goes through my mind, but I tell the patient that Claritin-D comes in 12 hour and 24 hour formulas and in different counts. It's the same with most of the other behind the counter pseudoephedrine products.

If I'm up for it, I'll take the time to ask the patient about their symptoms and 90% of the time it turns out that they really don't "need" Claritin-D or whatever else they've come to the pharmacy counter to get. The magic of TV advertising has put an idea in their head that they need that particular product and by golly they're going to rush right down to the pharmacy for that magic elixir of life, but I'm not a fan of the side effects with pseudoephedrine and I'll talk people out of it if given the chance. 

I watch TV too and while I don't think there is anything unethical about the commercials, they do give people the idea that they "need" the product. I guess that's the way the world works with advertising, but when you're talking about pharmaceuticals, I think a better approach might be warranted... how about listing the nasty side effects like prescription drugs advertising has to do?

Now enjoy a funny Claritin-D parody:

Friday, September 19, 2014

Thursday, September 18, 2014

Overheard from the Dispensing Bench

"Is that the man giving me my flu shot?"

"Why yes," the technician answered. "He's the pharmacist."

"But he looks so mean!"

Wednesday, September 17, 2014

Try this at your Restaurant

"That was one delicious meal. Please give my compliments to the chef," I said to the waitress.

She thanked me for the patronage and handed me the bill.

"What's this for?" I ask.

Stunned, she says "That's your bill."

"Oh, it's covered by my Visa," I said.

"Well..." she says, rolling her eyes, "we're going to need to SEE your Visa card."

"I don't have it with me. Just look it up on the computer or call Visa. They can give you my information. Besides, it's the same as last time I was here."

And yet, if this was actually a true story, you'd scoff at the insanity of it all.

BUT this is an every day occurrence in the pharmacy. EVERY SINGLE DAY. People come in with a prescription and do not have their prescription card. Some people can't even tell you what the name of the company is that handles their prescription insurance. Others have a card two or three years old. And no matter how busy you are they expect you to just magically make it appear.

It doesn't work that way in pharmacy, people.

Tuesday, September 16, 2014

Zithromax is now Controlled?

"Is Zithromax a controlled substance," he asked as I was filling his prescription for a Z-pack.

"No," I replied. "I know lots of people want a Z-pack for the least little thing, but to my knowledge it has no addictive qualities."

At this point, maybe five minutes has passed since the patient first walked in and I'm in the middle of filling his prescription.

"Oh. I'm going to complain! I asked the doctor's office if they wouldn't mind calling this in for me so it would be ready when I got here," he says in a grumpy tone.

"This office calls in medications all the time," I said.

"The lady told me Zithromax is a controlled substance and I had to hand deliver the prescription," he says. "I'm going to call them up and complain!"

We're now at the seven minute mark and I'm heading toward the register with his Rx ready. He's my first patient of the day and there was no wait. I had his prescription ready in less than ten minutes, but he's mad because the office wouldn't call it in ahead of time for him. He must have one damn important job if he can't wait ten minutes.

Who's to say what really happened at the doctor's office, but I wouldn't be surprised if that's exactly what happened. I've had office staff lie to me over the phone. It actually happens all the time. My personal favorite is, "We never received your fax" as I'm hold a fax confirmation in my hand.

Or maybe Zithromax was bumped up to a C-II controlled status and I didn't even know about it?

Monday, September 15, 2014

The Return of Respect Starts with Us

There's no one person to blame. It just kind of happened. Maybe it happened when we stuck a pharmacy inside a grocery store. Or maybe it happened when they opened the first pharmacy with a drive through window. I don't know when it happened exactly. Neither do you. What we do know is that our profession changed somewhere along the way.

Yes, we're one of the most trusted professions, but we're treated with much less respect now than we used to be. When people come into Goofmart Pharmacy, do the script push across the counter, and tell me they're going to be back for their prescription in five minutes (without having any idea of the current situation or how many people are ahead of them in line), it shows the lack of respect people have for our profession. When people tell me that all I have to do is "slap a label on it," it shows the lack of respect people have for our profession. When people come in after having seen the doctor ten minutes ago expect their prescription to be filled and ready to pick up, it shows the lack of respect people have for our profession.

In some cases it might just be a matter of having had enough of waiting. When people go to their doctor, wait fifteen minutes to get taken to an exam room, wait another ten minutes to actually see the doctor, then get only five minutes with the doctor and given a handful of scripts, they've had enough. They don't want to wait anymore, and I can't blame them. But a patient can't go through this routine and then expect things to magically accelerate at the pharmacy. Yes, your doctor did see you and prescribed a medication. BUT we're not only filling your prescription, we're ALSO making sure it is safe for you, is appropriate for you, and making sure you're getting the right medication. That's our job and whether you like it or not, this part takes time too.

The e-Script system reduces a little of the workload in the process. By eliminating some of the issues doctors have with writing clearly (there's so many of them you can't possibly imagine) the e-Script system has introduced a new set of issues. Office staff that are untrained with the system or don't know the medications that well (such as the difference between immediate release and extended release) gum up the process quickly. Unfortunately, because of the way the doctor office works, getting it fixed rapidly is almost impossible. For a patient that thinks we have a magic phone line which instantly connects us to the prescriber, any additional wait time seems ridiculous to him or her.

My biggest complaint with the e-Script system is not the system itself, but the way patients perceive it. In some cases, this perception is created by the doctor. I have had patients tell me, patients who actually know better, that their doctor will fiddle on the computer with their prescription and announce to them, "Ok, I sent it over. It's ready. Go get it." In other cases, patients themselves think that once the doctor hits the SEND button a label prints out on our end and a team of technicians instantly fills the prescriptions. I have had to tell too many people that sometimes it can take up to an hour before we ever see it on our end. "But I saw my doctor send it" they say, not knowing that it's not like email. Even if it was like email, who checks their email every 30 seconds? (Yes, I know there's some people that do check their email every 30 seconds. I'm talking about NORMAL people).

If we're going to return some respect to our profession, we as pharmacists need to stop these incorrect perceptions. I have patients who are also doctors for other patients. I do my part by gently telling them how our side of the process works. If you're a pharmacist, I encourage you to do the same. When you get a patient that runs in expecting a prescription to be ready for them when they walk in and you determine that the doctor has given them the idea that it would be ready for them immediately, take some time to call the office and again, GENTLY tell them how it works. Tell them how much you appreciate the fact that they care for our patients, BUT that you're not running a fast food operation. If you're nice, you'll get a message across eventually.

As for patients, do your part to train them as well. Decide on a wait time with your staff depending on various situations and stick to it. Exceptions can and should be made for crying babies, but don't push yourself and risk patient safety just because they're in a hurry. Patient safety is paramount, and it is what we're all about as pharmacists. Don't let your company bully you. Don't let metrics pressure you. Don't let whiny patients coerce you. Do what is right for the patient by carefully checking each and every prescription. 

Only then will the respect for our profession return.