Tuesday, May 23, 2017

Ignore the Customer to Maximize Sales

Last week we had some corporate people, The Authorities... about six of them, fussing over the protein supplements like Ensure. These supplements are on a smaller aisle that's hard to get through and with the six of them crowding the aisle it was an area to avoid.

All of them ignored a little old lady that was trying to get some Ensure for herself. She didn't try to interrupt them but they didn't even bother to move or act like she even existed. It was pretty obvious she was there but they all ignored her. I was stunned at how they're obviously here to do something to improve sales while ignoring the customer. 



I was busy and got distracted with something else but the next time I looked up she was trying to get in the aisle from the other side with the same issue. At that point I sent a technician out to help her. The corporate people acted put out because they had to move.

And these are the people that bark at us if someone doesn't get helped within 1.5 minutes after stepping up to the counter.





Monday, May 22, 2017

10 Things NOT to do when Writing a Prescription

Dear Prescriber,

Here's TEN things you should NOT do when writing a prescription:

1. Don't BOLD the last zero


When you do this, it makes it look like the extra zero was added to the prescription and not by you. And you know what that means? Your patient is going to wait while we try to get a hold of you to clarify what you meant.

2. Don't write multiple prescriptions on one blank

We know you're all trying to pinch a penny here and there, but one prescription per prescription blank, please. There's legal requirements on our end that require us to put labels on the back of the prescription. And when you load up the front with multiple medications it makes it harder to read as well. 

3. Don't leave the refill spot blank

If you leave this spot blank, a nefarious patient will be happy to fill it in for you. And if we see 15 refills on a controlled substance prescription, we'll be calling you about it.

4. Don't write 1.0 or .5

After all these years I'm still surprised, but yes, a lot of prescribers are still writing the number 1 as "1.0" which I'm sure you can guess can be misinterpreted as "10." 

The same goes for decimals. If you're writing for 1/2 half of a milligram, please use "0.5" and not ".5" -- in many cases that decimal can be easily overlooked.

5. Don't write illegibly



If you've EVER had a call from a pharmacist asking what you wrote on a prescription... even just one call, then it's time to reevaluate whether you should be physically writing prescriptions. With e-Script technology it's time to stop this nonsense. At the very least, get an assistant or someone with decent handwriting to write for you.

6. Don't write a book

I'm sure you have a novel idea on how prednisone should be tapered, but we've only got about 140 characters on the label. 

7. Don't invent new drugs



We know a lot of you prescribers have a "God" complex, but the reality is that you can't just invent a new medication. Please stick to the already approved and available medications.

8. Don't invent new dosing regimens or indications





Let's stick to the standard dosing with medications unless there's a really odd off-label dosing protocol or another reason why you want the med to be taken the way you've prescribed. If that's the case you should add your reasoning to the prescription. Otherwise, you're either going to get a call from us or your fax machine will be printing out a "prior authorization" request form.

9. Don't give the prescription to the patient until you've proofread what you've written







Just a quick look... 30 seconds at the most, can save oodles and oodles of time at the pharmacy. We're going to check each prescription, and when we find mistakes, we're going to call your office, have you paged, bother your staff, and generally pester you over and over until you clarify the Rx.

10. Don't hand over the prescription without indicating who wrote it

Sounds pretty simple, right? Oh ho ho ho, you'd be amazed how many prescribers sign scripts with an illegible scribble without indicating who they are in any other way. This is especially true for you hospitalists out there. Yeah, you.

If there's multiple physician names on the top, circle your name. Or print your name by your signature, legibly. Don't think for a minute the patient is going to remember. Half the time they don't have any clue who they saw. Don't make us guess who wrote the prescription or... guess what, we'll be calling the office to find out, and that wastes both of our time.

Thank you,

Every pharmacist, everywhere

Saturday, May 20, 2017

20 Minutes of a Typical Day at the Pharmacy


This is 20 minutes of time compressed into one minute at a CVS pharmacy. It just as well be any retail pharmacy because we're all busy.

Now imagine how this chaos gets insanely worse with the introduction of having a tech or pharmacist distracted because of GoodRx nonsense.

GoodRx adds TIME (See this BLOG POST) to an already burdened pharmacy. Eventually someone is going to get hurt. 

It's time to end this nonsense.

Thursday, May 18, 2017

Nice Try, Patient

The Old Switcheroo Trick

A patient comes to the register and asks to pick up his medication. I look in the will-call and there's nothing there for him. He says the computer called him, but then reluctantly admits that it was sometime last week. I tell him that we return things to stock after nine days. 

So I look at his profile and tell him it was probably his Lipofen. I fill his Lipofen for him in 3.5 minutes, he pays $25, and he's out the door.

I'm busy with other things and leave the empty bottle of Lipofen on the counter. I'm alone at the pharmacy today and throwing it in the trash would have meant me taking an extra step, so what the heck, it can wait until later. I'm taking lessons from Lazy RxMan.

A little while later Mr. Lipofen appears at the window with the bag, the receipt hanging out, and a labeled bottle of Avodart. He wants to know why I filled his AVODART when he needed LIPOFEN and he wants a REFUND of the $60 co-pay. Somehow Mr. Lipofen thinks that I'm going to fall for this voodoo and give him a $60 refund. 

"Uh, no... I filled your Lipofen." I show him the empty bottle of Lipofen that was conveniently on the counter and easy to grab. "It was $25." At first he tries to argue with me, but then looks at the receipt and realizes it says $25. The only thing I can surmise is that he thought he would somehow fool me into giving him a $60 refund when he paid $25 before.

Nice try, but the old RxMan couldn't be fooled today. Being lazy paid off.