Tuesday, April 30, 2013

Todd Soonler got an MRI

This is a copy of a copy of a copy, so it may not be that readable. This was an actual prescription for Percocet presented to a local pharmacy which discovered that the patient had previously filled the same medication within a few days that this one was presented. That pharmacy took the Rx and wrote "Too Soon, got on 1-29-9" so that any other pharmacy would know that it was too early to refill this prescription.
This drug seeker was not going to be deterred, however.  Using amazing brain skills and a pen that doesn't match, he tried to turn it into a scribble about someone named Todd Soonler and an MRI, and actually presented it to another pharmacy. Sharp thinking there, Tex.

Monday, April 29, 2013

HOW to REALLY Piss off your Pharmacist

Don't use the automated line -- press zero to talk to us, especially on Monday morning.

Hand us your empty Rx bottle and inform us you'll be back in a few minutes for your refill.

Wait until your prescription is paid for THEN hand us a manufacturer coupon.

Hand us a prescription dated several days ago and inform us that you need it right now.

Write a check at the register and take your time doing it like we have nothing else to do.

Act like you're in a hurry to get your Rx filled THEN after you pay for it you're no longer in a hurry.

Call and ask to talk to the pharmacist when your request or question can clearly be answered by the technician.

Ask us to ring up a bunch of crap with your prescription because you're too damn lazy to use our automated check out up front.

Ask me to talk to your doctor on YOUR cell phone. Ewww!

Start talking to me or ask me a question when I'm clearly on the phone.

Ask me to fill another prescription of yours when you just paid for one and there are other people in line.

Ask me for an early refill on your narcotic and give me some bullcrap story. Really, we've heard them all.

Tell us there you don't have new insurance and let us scramble around trying to figure out why your old insurance doesn't work any more.

Ask me for pharmacy advice then not listen to me.

Ask me a question when I'm helping another patient. 

Call the pharmacy and act like we're the switchboard for the rest of the store.

Ask me to refill your narcotic early. Just don't, ok?

Ask me to loan you some Percocet and tell me it's ok because you're bringing in an Rx from your doctor later in the week.

Write a check. Come on, it's 2013. Use a debit card, you dolt.

Try to show me your rash, lesion, or wound. We really don't want to see it.

Ask me why YOUR doctor hasn't called back on your refill.

Tell me you know that "something" is absolutely true because your neighbor's brother's cousin said so.

Tell me you know what you read is absolutely true because you read it on the Internet.

Refer to brand medication as "the real stuff."

Tell me all I have to do is "slap a label" on your medicine.

Write on your prescription. DON'T DO THAT.

Tell me your prescription is cheaper somewhere else. If that's true, GO THERE.

Ask me where the bathroom is. Come on, the store is not that big. You can find it.

Tell me I "never work anymore" when I've been here 40+ hours a week.

Ask me for anything recommended by that quack Dr. Oz. The man is a loon.

Ask me for anything "homeopathic."

Ask me for the "best" of anything. Of course we're going to recommend the best. Duh.

Say you have to have brand because you're allergic to generic.

Say you have to have brand because our generic "didn't do anything" for you.

Say you must have a specific generic manufacturer.

Ask me for advice when you get your medication filled at our competitor across the street.

Ask me for something in the store that's not pharmacy related, at all. No, I don't know where the [insert anything non-pharmacy related here] is located.

Ask me for a kleenex, use it, then leave it on the counter.

Ask me to scan your club card AFTER the transaction is complete.

Hand me your Medicaid card while holding car keys for a Mercedes, Lexus, or some other fancy car. I drive an old beat-up Camry.

Hand me your Medicard card then come up to pay for your prescription later with a Starbucks in your hand.

Hand me your Medicaid card and act like that means we're supposed to ignore all other pharmacy patrons and have your Rx ready in 30 seconds.

Call the pharmacy and ask to be transferred to another department. We're NOT a switchboard.

Stare at me through the glass while I'm filling your prescription. 

Go stand at the register and stare at me after I've told you it's going to be 15-20 minutes before your Rx is ready. We have an expensive waiting room. USE IT.

Press zero to talk to the pharmacy when our automated line tells you we have an Rx ready for you. Just come and get it or don't come and get it. We don't need to hear from you. Either you pick it up, or if you don't, we will return it to stock. DON'T BOTHER US.

Call to tell me you need an Rx filled that YOU know is already on auto-refill. OMgosh that's annoying.

Authorize a refill to be picked up later in the day then show up in an hour to get it.

Keep calling the pharmacy WHEN I've TOLD YOU I WILL CALL YOU when your refill is authorized.

Ask me to fill a prescription for you on the spot because you're a prescriber and you need a Z-pack while you're in town. 

Ask me to break the law for you in any way as a favor. I'm not going to lose my job for you, sorry.

Saturday, April 27, 2013

Yes, you SHOULD eat 5 Meals a Day!

Healthy eating is a such a good idea. Maybe I'll start giving that a try. Apparently, small meals spread out throughout the day seems to be the way to go these days. Here's a link to some health recipes and an infographic on small meals.

Friday, April 26, 2013

Favorite Phone Call of the Week

<Ring, Ring>

"Thank you for calling the pharmacy. This is Crazy RxMan. May I help you?"

Caller: "Do you have any flu shots left?"

"Yes, we have flu shots left. I don't know that you'd want one, however. As it turns out, this flu shot wasn't that appropriate for the flu strains circulating around this year. Besides, flu season is pretty much over now."

Caller: "How much is it?"


Caller: "I'll be RIGHT down!"


Thursday, April 25, 2013

Salt is our Enemy

Check out the MILLION HEARTS website with great information on Heart Disease, Stroke, and Cardiovascular Disease.

Heart Disease

Heart disease refers to several types of heart conditions. The most common type in the United States is coronary artery disease, which can cause heart attack, severe chest pain, heart failure, and irregular heartbeat. Several factors contribute to heart disease, including genetics, high blood pressure and cholesterol, and lifestyle factors such as smoking, unhealthy diet, and lack of exercise.


Stroke is a brain attack that occurs when blood flow to the brain becomes blocked. This can be caused either by a blood clot or by a burst blood vessel in or around the brain. Lack of blood flow during stroke can cause portions of the brain to become damaged, often beyond repair.

Cardiovascular Disease

Cardiovascular disease is a broad term for all diseases that affect the heart or blood vessels. This includes heart attack and stroke as well as conditions such as high blood pressure, coronary artery disease, and aortic aneurism.

See original INFOGRAPHIC

Wednesday, April 24, 2013

Keeping a Straight Face

Man, late 50s, early 60s, short, round, balding, heavy New York accent, an average looking Joe, steps up to the pharmacy window.

"You're the pharmacist, right? I trust pharmacists more than doctors and dentists. You guys really know your stuff."

smile and say, "How can I help you?"

"Do you think performing oral sex on a woman causes gum disease?"

"Uh, I, uh..." Average Joe doesn't give me a chance to respond...

"Yeah, I do that a lot. Been doing it for years. Lots of women. They like it. I like it. I talked to my dentist and he says I have gum disease. So I ask him if he thinks I could have gotten it from all my years doing the oral sex thing and he says no that's not possible. So then I ask my doctor and he says the same thing. But I know there's lots of germs and viruses and things down there so I thought I would ask the pharmacist because I'm not stopping what I do but I want to know what there is out there that can prevent this gum disease because like I said I'm not stopping because I'm good at it, ya know, and why would I stop something like that if I'm good at it, right?"

"I... uh... yeah" is what's coming out of my mouth because I have no idea what to say. No idea. 

Average Joe continues, "So what can I get that will help with the gum disease? I don't want gum disease because that's a big turn off to the ladies when you want to do that to them and no matter how good I am at that they're not going to want to let me do that if I have gum disease so I need something I can tell my doctor about because I saw on Katie Couric [see this INFOGRAPHIC for more info] that you can get cancer from oral sex. I even video taped it for a class I teach on oral pleasure at the university. So what do you have that might help me?"

All I can muster out is, "Peridex?" I show him a bottle of the generic.

Average Joe continues: "Yeah, that's what the dentist gave me. I've been swishing and spitting all over the place trying to stop this gum disease with that. I think maybe I'll keep using it because it can't hurt, right? And I'm not stopping because I'm pretty much an expert and I'm not going to stop for gum disease. And you know..." 

Average Joe leans over the counter, and whispers, "These ladies ain't gonna let me stop either." He winks at me.

Joe straightens up and continues, "So yeah I'll keep using that Peridex stuff like you said because that's pretty much the best stuff out there to stop this gum disease and to hell with these doctors and dentists. I knew the pharmacist would know what's going on. You guys know all about these magic drugs like you're Harry Potter and the Emperor's Sword, right?"

Average Joe winks at me again. The tech hands me a script to check-- some poor lady is wheezing while waiting for her Ventolin at the pick up window. I reach over to check it and then look back to Average Joe.

"Well I can see you're busy. Boy you guys really know your stuff. Thanks for the good information and help. I appreciate you guys."

Average Joe walks off. I promise you I kept a straight face the entire time.

Tuesday, April 23, 2013

Reasons for Early Refill

Reasons you want to refill your narcotic early:

You lost it

Someone stole it out of your purse/car/medicine cabinet

You're going out of town where they don't have pharmacies

You left it at the motel room

You left it in the cab

You left it on the bus

You left it on the airplane

You left it at the restaurant

You left it at your in-laws' house

Because you're willing to pay cash for it

You're going on a three month cruise and won't have access to a pharmacy

Because [insert Holiday coming up] is next week

Even though we have a pick-up signature captured on our computer, you insist you didn't actually pick them up last month

You just had bad news and you really, really need it

Because "none of the pharmacist's business" is a good enough reason

It was accidentally thrown away

Your kids are stealing them

The count must have been off from the last refill and now you're short this month

Even though it says to take ONE a day, TWO must be better

You can't find your current medication

They fell into the toilet

They fell into the sink

They fell into your bowl of cereal

The last refill "smelled funny"

I have to otherwise you said you'll complain to my manager

Your doctor said it is ok

Your doctor who can't be reached said it is ok and I'm just supposed to take your word for it

Because there is only 28 days in February so you're being screwed out of 3 days

Because you like to "stock up" just in case we don't have the medication next month

You don't really need them -- you just don't want to have to drive all the way down here next week

Dr. Oz said it was ok

Oprah said it was ok

Dr. Oz said it was ok while on Oprah

You ran out because you share it with your spouse

You ran out because your ex-spouse stole them

Because your insurance is expiring at the end of the month and you don't want to have to pay cash for it

You worry about Zombies and/or Robots

The dog ate your last refill

Scotty "beamed" them up

Because you have to come up with some sort of "believable" excuse because you're lying to everyone, including yourself, that you're a damn narc addict and you just can't admit it

Monday, April 22, 2013

Miss Loosey needs a Sleep Aid

You remember Miss Loosey?

She was in last night fifteen minutes before closing time. She's asking me for a "sleep aid" to help her fall asleep. She's out by the pain relievers where we also happen to keep the sleep aids.

"I want something to help me sleep," she says. "What's in these called Advil-PM?"

"That's Advil and Benedryl together in one tablet. It has ibuprofen and diphenhydramine in it. The Advil will help you if you're having any pain issues and the Benedryl will help you get sleepy."

Miss Loosey replies, "I'm not having any pain. I just want to sleep."

"Ok, then how about this. Here's our store brand 'Allergy Relief' which is the Benedryl that is in the Advil-PM. It will help you get sleepy."

She looks at me funny. Her eyes squint and her head tilts back a bit. "But it says 'allergy relief.' I'm not having any allergy problems."

"I know that. This is the same as the ingredient in half of the Advil-PM. The brand name is Benedryl. See here..." I point to the word DIPHENHYDRAMINE on the box of Advil-PM. "That's the generic name for Benedryl. It's the SAME medicine in this one called Allergy Relief." I point to the word DIPHENHYDRAMINE on the box of Allergy Relief. You get a whole box of 100 count for less than half the price of Advil-PM 24 count. 

"But I'm not allergic to anything. I just want a sleep aid. It doesn't say 'sleep aid' on the box."

I try again. "Diphenhydramine is an anti-histamine that causes drowsiness. That's why it is in these other medicines for sleep. It's the SAME medication." I point to the back of the box where it says "May cause drowsiness."

"But it doesn't say SLEEP AID on the box. What's this ZzzQuil stuff over here?" she asks.

"That's the same ingredient as Benedryl -- see, here on the box... DIPHENHYDRAMINE. It's the SAME medication! Seriously, you can save a lot of money by buying the store brand."

I wanted to say she could use the savings to save up for another Plan B, but I resist.

"But it doesn't say SLEEP AID on the box."

I pull out my pen, cross out the words "Allergy Relief" on the box and write the words "Sleep Aid" at the top. I set it back on the counter. "There, now it says SLEEP AID."

I hear the phone ringing back in the pharmacy. I excuse myself and rush back to the pharmacy.

A few minutes later I see Miss Loosey walking by with a box of ZzzQuil in her hands. And another blog story is born.

Saturday, April 20, 2013

Too Busy at the Pharmacy?

Corporate headquarters recently shipped both male/female versions of the "Foldaway Urinal" to our pharmacies across the nation. This is to help pharmacists meet their biological needs while maintaining the metrics. No longer will pharmacists be allowed to deviate from the work flow for a personal urine flow. Now we will be able to keep working throughout the day with reduced technician hours and yet maintain the script count! 

"The expectation is that all pharmacists will utilize these storage units going forward," as stated in a recent email from our regional manager. 

Friday, April 19, 2013

TOP TEN Profitable DRUGS at My Pharmacy in 2012

Here is a list of the TOP TEN most profitable drugs dispensed at my pharmacy in 2012:

1. Quetiapine 200mg (Seroquel generic)
2. Fluvirin 2012-13 (flu shot)
3. Oxycodone 30mg
4. Zolpidem 10mg (Ambien generic)
5. Fluzone HD 2012-13 (high dose flu shot)
6. Endocet 10/325mg (Percocet generic)
7. Oxycontin 40mg
8. Azithromycin 250mg Z-Pack
9. Oxycodone/APAP 5/325mg (Percocet generic)
10. Montelukast 10mg (Singulair generic)

And thus you see WHY retail pharmacy is CRAZY for flu shots! Corporate will pay BIG MONEY to refurbish/expand the retail pharmacy for flu shots but ironically won't fork over more tech hours so we can deliver seamless service to other pharmacy patrons.

Thursday, April 18, 2013

Know When to Fold 'Em

An insanely tall lady in her late 50s approaches me at the counter. She clearly has conjunctivitis (pink eye) and she clearly needs an antibiotic, but she wants to argue with me that she has the same exact thing she had in 1984 and she asks me what we have over the counter for her eye. I tell her that she needs to see a doctor PRONTO for an antibiotic. Why people keep thinking that we have over the counter antibiotics is beyond me?! We've never had that. I'm sorry.

During the course of our conversation, she somehow gets the idea in her head that I have told her she needs an oral antibiotic. I correct her-- no, she needs something for the eye. I tell her there are antibiotic drops for the eye and make a couple of suggestions but that she really needs to be examined by a doctor. She asks me if the "drops" will upset her stomach and once again I realize she thinks I'm suggesting an oral antibiotic. Mind you I NEVER said anything about an ORAL antibiotic. Finally she gets the message and leaves after touching everything on the counter and now it's time to disinfect everything.

The next day I arrive midday and the tech tells me that the insanely tall lady was there in the morning with an Rx for Erythromycin ophthalmic ointment and that she was upset because I told her to talk to her doctor about "drops" for the eye and she wondered if I gave her wrong information. My partner Mickey assured her that ointment was just as good as drops and she would be fine. I think the worst of it is now over...

Later in the day, I see her approaching the pharmacy once again. This time she has several file folders in her arms and she's heading my way. As a pharmacist you need to know when to fold 'em, know when to walk away... and know when to run. 

I should have run!

She opens her folder with pages and pages of hand written notes about her eye issue from 1984. No, I'm not kidding. She tells me about EIGHT different medicines she was given for her eye condition in 1984 and how each one caused her some side effect or problem. She ended up going to three different doctors and finally ended up at a dermatologist who said she had ocular rosacea.

And so now the insanely tall woman starts grilling me about the ointment and what side effects she's going to experience. I counsel her as best I can, but there are a certain number of people out there that are just... how shall we say... sensitive to everything or think that every medication causes them an issue. I tell her that because of her past experience she will likely experience some side effect (who knows what) but that I think the doctor made the best decision with the ointment for her. She leaves, but I have a feeling there will be detailed notes added to her 2013 file with my name in it.

On a warm March mornin' in a pharmacy behind the counter,
I met up with the tall woman; with a red eye that would weep.
She continued askin' me questions
Until she allowed me to speak.

So I says, "Lady, I've made my life out of readin' people's faces,
And knowin' what their conditions are by what was in their eye.
So if you don't mind my sayin', conjunctivitis is your case,
You need an antibiotic for your eye, was my advice."

So she returned the next mornin' with a script for an ointment
She wasn't happy cause I told her to get some drops for her sight
I'm not an eye guy, but that ointment was just right,
If you're gonna take my advice, ya gotta learn to listen, alright!

You got to know when to hold 'em, know when to fold 'em,
Know when to walk away and know when to run.
You never fill a prescription when you're stuck at the register,
There'll be time enough for countin' pills when the counseling is done.

Now Ev'ry pharmacist knows that the secret to survivin'
Is knowin' what scripts to throw away and knowing which ones to fill.
'Cause ev'ry patient is a winner and ev'ry patient a loser,
And the best that you can hope for is to give them the right pills.

So when she finished grillin', she turned away from the window,
Closed up her 1984 folder and headed out of town.
And somewhere in the darkness, I know she'll be back...
My times a comin', she'll be back with a frown.

You got to know when to hold 'em, know when to fold 'em,
Know when to walk away and know when to run.
I'll know when to fill a prescription or when it's the right time,
To run out of that pharmacy before the countin' is done!

Wednesday, April 17, 2013

TOP DRUGS of 2012 at My Pharmacy

Below is a list of the top 20 drugs dispensed by number of prescriptions:

1. Zolpidem 10mg (Ambien generic -- for sleep) 
2. Oxycodone/APAP 5/325 (Percocet generic -- for pain)
3. Fluticasone 50mcg (Flonase generic -- for seasonal allergies)
4. Azithromycin 250mg Z-Pack (antibiotic)
5. Fluvirin 2012-13 (flu shot)
6. Simvastatin 20mg (Zocor generic -- for cholesterol)
7. Amoxicillin/Clavulanic Acid 875mg (Augmentin generic -- antibiotic)
8. Hydrocodone/APAP 5/500mg (Vicodin generic -- for pain)
9. Cephalexin 500mg (Keflex generic -- antibiotic)
10. Lisinopril 10mg (Zestril generic -- for high blood pressure)
11. Lisinopril 20mg (Zestril generic -- for high blood pressure)
12. Oxycodone 30mg (for pain)
13. Endocet 10/325mg (Percocet generic -- for pain)
14. Sertraline 100mg (Zoloft generic -- for depression)
15. Tramadol 50mg (Ultram generic -- for pain, sleep)
16. Alprazolam 0.5mg (Xanax generic -- for anxiety)
17. Alprazolam 1mg (Xanax generic -- for anxiety)
18. Amoxicillin 500mg (antibioltic)
19. Crestor 10mg (for cholesterol)
20. Singulair 10mg (for seasonal allergies) 

The numbers also indicate that my pharmacy dispenses the number two on the list (generic Percocet) more than one time per day. Cialis is more popular than Viagra.

So basically the population of patrons at my pharmacy is composed mostly of anxious people who can't sleep, get sick, have high blood pressure and high cholesterol, and are in whole lotta pain.

Tuesday, April 16, 2013

You Running Late?

It's Sunday morning and I'm opening the pharmacy. I'm always on time. But no matter how many years we've been here, people have it in their head that we open at the same time on Sunday as we do the rest of the week. We don't. We open TWO hours later. It's posted at both windows, on the front of the store, our business cards, and if you call the automated line it will tell you when we open too.

But it happens every Sunday I work. Either someone is there at the window waiting for me to pick up or someone wants to hand me a script thinking their going to get it filled in 3.5 minutes. "You running late?" is something I hear quite often. No, I'm not running late. I'm actually early, you dolt. But I can't say that. I just try to remind them that we open two hours later on Sunday.

The last time this happened a guy set his prescription on my cash drawer. I was carrying a bunch of stuff including the cash drawer and although it would have taken me maybe 30 seconds to open the door and put down the stuff, he couldn't wait that 30 seconds and set it on the cash drawer I was holding. I told him yes, I can fill it in 3.5 minutes but I'm going to need 10 minutes or so to fire up the ancient Windows computers and enter 47 passwords to get to a filling screen. That's why I'm there at least 15 minutes early. Keep in mind that's 15 minutes I do NOT get paid for. I'm giving the company a free 15 minutes because their computers are not right ready to go at the opening bell. 

Sometimes I'm lucky and get into the pharmacy before someone is there, but then the next thing that happens is someone knocking on the window. It happens every Sunday I work without fail. Knock knock knock... "Are you in there, Danny Boy? Jack is here and I need my prescription pronto!"

And come to think of it now... pharmacy is pretty much like The Shining  in a lot of ways... Let's explore this further:

* Pharmacists really don't have Shining, -- but prescribers and patients just expect us to be able to read their minds and hear their thoughts. 

* When Wendy interrupts Jack, it's just like when a patient interrupts us counting their medication. We want to say, "Let me explain something to you. Whenever you come in here and interrupt me, you're breaking my concentration. You're distracting me. And it will then take me time to get back to where I was. You understand?" And just like Jack loses his mind by constantly getting interrupted, we pharmacists slowly lose our minds every time we're interrupted.

* The grocery is pretty much just like The Overlook... "We've got canned fruits and vegetables, canned fish and meats, hot and cold syrups, Post Toasties, Corn Flakes, Sugar Puffs, Rice Krispies, Oatmeal... and Cream of Wheat." And as the pharmacist, we're expected to know right where everything is!

* When a patient asks us to do something illegal or immoral, we feel like getting angry just like Jack and yelling, "Do you have the SLIGHTEST IDEA, what a MORAL AND ETHICAL PRINCIPLE IS, DO YOU? Has it ever occurred to you what would happen to my future, if I were to fail to live up to my responsibilities? Has it ever occurred to you? HAS IT?"

 * If I dare to think I can get out of this hell hole, Grady will set me straight. "I'm sorry to differ with you sir, but YOU are the pharmacist. You've ALWAYS been the pharmacist!"

* And don't even ask me about trying to run prescriptions on insurance for twins!


Monday, April 15, 2013

Alienating the Left

Recently I posted another article about Levaquin Lady. Some readers took offense with the following statement from the article:

Levaquin Boy was feeling sorry for his mom at home. She was discharged early because of new hospital rules regarding reimbursement which are a direct result of major changes in healthcare, but I wouldn't want to point any fingers at the culprit because there's just soooo many readers of this blog out there that are quite happy with the way things are going healthcare-wise. Someone might say "Socialist Libtards," but I won't.

One comment states:

I used to think that your blog was semi-amusing, and I started reading it because it is on Dr. Grumpy's recommended list. The increasing number of bitter, insulting political comments have changed my opinion. It's your blog, your choice, but I'm not sure why you'd want to alienate left-leaning readers.

Semi-amusing? Woo hoo! Thank you! That's a big step up from my family members who don't find it amusing at all! But I have to ask: where have you been the past thirty years? The media in general, but primarily newspapers, television, and Hollywood, has been on an anti-conservative bent FOR YEARS. From digs on Dan Quayle to George W. Bush to John McCain, it's a never-ending saga of "bitter, insulting political comments." Every week on Saturday Night Live we're treated to some sort of dig on conservatives. I laugh at something when it is funny whether it is a dig at a liberal or a conservative. I laughed when they made fun of Dan Quayle. He said some wild crazy things and the media went out of their way to publicize it and make fun of it. TODAY you're hard pressed to hear about the stupid things that Joe Biden says all the time even though he says A LOT of stupid things. Just the other day Biden was telling people to use a shotgun instead of an assault rifle because it won't put holes in the wall. Really?

The irony is that my statement about the healthcare reforms in this blog article points out the fact that the new healthcare policy actually has a negative effect on the patient and is really all about money, not the patient. To me this would be something that a liberal would suggest as a conservative reform, not vice versa. Part of the healthcare reform (that Nancy Pelosi instructed the congress to vote for "so we can see what's in it") directly affects the reimbursement that hospitals receive for Medicare patients. One small part of that reimbursement is that the patient must be discharged according to the healthcare bill's predetermined chart, NOT based on when the individual patient should be discharged according to their own needs. OTHERWISE, the hospital does NOT get paid, at all. I'm sorry people don't seem to understand this simple concept, but ALL businesses operate on profit. No profit = no incentive to produce. Unless the hospital can make a profit, they're not going to stay in business.

Every patient is different and for all the Levaquin that Levaquin Lady has had in the past, kicking her out of the hospital too soon was a really bad idea. And here's another aspect you probably don't know about. When a patient is discharged according to this predetermined schedule, the new directives also dictate that IF the patient returns to the hospital within a certain amount of time with the same ailment, the hospital will not be reimbursed for EITHER visit. The healthcare directive is forcing hospitals to discharge patients early then if they come back due to complications being discharged early... tough luck, no reimbursement for you. Tell me, HOW is this beneficial? It's NOT, except to stick hospitals with having to spread the cost of these patients onto other patients' bills.

Over the next decade you will see massive changes in how care is provided based on this bill. Hospitals WILL close. Have you noticed how urgent care centers are popping up everywhere? That's because they know this. This is the future of healthcare. Doctors will stop taking Medicaid and Medicare patients because they won't be able to get paid for seeing these patients. Some doctors are already declaring bankruptcy. Read this article. Again, let me remind you, all businesses operate on profit. No profit = no incentive to produce.

You're kind of silly. The corporate blockheads are making your work life miserable because of their greed, yet you want healthcare completely in their hands? Not sure if I'm left or right, but I'd love to know what you think is the answer here.

I'm not silly. I am on the battle line seeing what's really happening as its happening. Nothing I said indicated that I want corporations to run healthcare, but I certainly don't think government should be involved in it either. One thing I know for sure: Socialism is not the answer. If you can tell me ONE example of anywhere in the world where socialism has worked, I'll reconsider. You can't. Look at history.

 Janine said...
I have to agree with the other two posters. Clearly you hate the thought that the gov't might try to provide health insurance to those unable to afford it any other way, but I don't understand why. I also don't understand why you think it will make your life worse, since your problem seems to be that you hate the company you work for. 

I don't hate the thought that the government might try to provide health insurance to those UNABLE to afford it any other way. What I see on a daily basis is massive abuse of the Medicaid system by people who ARE able to pay but are taking advantage of the system. Here's an EXAMPLE of how the you know the system is broken and is exactly what I'm talking about, and NO it isn't an isolated incident. Abuse of Medicaid happens all the time. There is a growing, pervasive ENTITLEMENT attitude out there of YOU owe ME and it just has to stop. This abuse is widespread and it costs us all money.

Also you overlook a very real problem in this country. For 15 years I was self-employed and bought my own health insurance. Then the recession hit, my income plummeted yet my health insurance had risen to $800/mo. I had no choice but to drop it (along with a host of other "necessary" things like collision on my car, healthy food, etc.). For 5 years I lived in fear of becoming really ill. No matter what might be wrong, I had to hope it would heal on its own because no doctor would even see me without insurance--and the ER is much too expensive for non-emergent issues. It's a horrible feeling to have to live with such fear. Recently I was able to again get health insurance for a price I could afford because I still spend NO MONEY on anything that isn't critical to existence, like food. No restaurants, newspapers, vacations, or unnecessary trips in the car. NOTHING. But I can afford health insurance again. Maybe your utter lack of compassion has something to do with the fact that while you don't like your job, it has always included some health insurance so you don't know what it's like to live in fear of dying of something easily curable just because no doctor will see you?

I am sorry for your situation but as you describe it you're one of a very few number of people using the system for the help it was designed for. You didn't abuse it and I don't mind a portion of my taxes going to people who truly need it and appreciate it. What I see is widespread abuse by people who take advantage of Medicaid and Medicare's lack of any ability to verify each patient situation. Too many people know that they can get help at no cost or virtually no cost just on a signature. And they DO take advantage of it.

I was self-employed for 20 years myself. I bought my own health insurance when I could afford it. I didn't always have health insurance and I paid out of pocket for the doctor/hospital cost for the birth of both of my children. I never thought that my healthcare was a "right" like life, liberty, and the pursuit of happiness, because it is not. I have a right to life, but I didn't (and still don't) expect my healthcare to be paid for by everyone else. That's the thing you have to realize... when people say THE GOVERNMENT is paying for Medicaid, that's not really true. Taxes from OTHER people are paying for Medicaid. I have no "right" to expect someone else to pay for my healthcare any more than I have the "right" to go to my next door neighbor and demand that he give me a gallon of gas out of his car because I'm short this week.

Maybe your utter lack of compassion has something to do with the fact that while you don't like your job, it has always included some health insurance so you don't know what it's like to live in fear of dying of something easily curable just because no doctor will see you?

As I said, I was self-employed too. I lived in fear too. I can sympathize with your situation because I lived it myself. BUT I didn't expect someone else to pay for my healthcare. I honestly am just appalled at this philosophy. It really makes no sense to me. Further, it is very ironic that you accused me of having an "utter lack of compassion" when I was lamenting the fact that Levaquin Lady was discharged BEFORE she should have been. I was showing one weakness in Obamacare that directly affects the patient and the hospital.  

And that's another thing: While I have health insurance, I don't have drug insurance because I only take one, inexpensive drug (synthetic/generic thyroid). But my local pharmacy chain charges me $30 for a month's supply, while WalMart charges me $4. So is WalMart subsidizing the other $26 in the hopes that I'll buy more than $26 worth of stuff while waiting for the prescription or is the chain ripping off those of us without insurance? What does it cost to make a thyroid pill? Something is seriously wrong with the way we do healthcare in this country and if there is any way that Omamacare will correct it, I'm all for it.

I don't know your community, of course. In mine, all the major pharmacies match the Walmart $4/month price for a bunch of medication, even if it is below cost. What's more, every pharmacy matches the other pharmacies' list. Each pharmacy has a different list, so in essence the actual list of medications available for $4 for a month supply is much larger than any one list. In some states they just give you an Amoxicillin Rx at no cost just to get you in the door.

Again, I don't know your specific pharmacy that's charging $30 for a month supply. But if we look at it under the idea that NO profit = no incentive to produce, it would make sense. Walmart is huge, the largest retailer in the world. And with that you get a huge, huge quantity discount. In retail, the more you buy, the cheaper the price. That's just the way it works. A small community pharmacy has to pay more for Levothyroxine (generic Synthroid) than Walmart. It's just a fact. A small community pharmacy has to pay more per square foot for rent. They have to buy their own insurance at a premium price (which you are aware of... you said you were self-employed). So EVERYTHING costs more for the small pharmacy as compared to Walmart. Do I think it justifies them charging $30 for a Levothyroxine Rx? I don't know. But I'm sure the manager/pharmacist there is simply trying to make a profit to feed his family based on income needed per number of prescriptions filled. What I can tell you is that you will get faster and better pharmacy service than at the giant Walmart where you're just an Rx number.

I recently transferred a couple of prescriptions from Walmart to my pharmacy. I was astounded at one of the labels on the bottle: "Please give us 48 hours advance notice for your refill." Really? 48 hours? I barely get 10 minutes advance notice at my pharmacy. Years ago I did a rotation at CostCo. Every single person that had to wait ten minutes JUST TO DROP OFF their prescription was absolutely shocked to hear that it was going to take 90 minutes to fill their prescription. And it did take 90 minutes with TWO pharmacists, NINE technicians, and me the intern to fill the prescriptions, because it was just that busy. Did we have time to really delve into the particulars of each patient? No. This was a pump-it-out factory of prescriptions.

Let's analyze the Levothyroxine issue for a moment. I don't have exact numbers, but we can estimate. Suppose your local pharmacy has one technician and one pharmacist. Let's further assume from start to finish it takes five minutes to fill your Levothyroxine prescription:

Technician, $10/hour, 5 mins = $0.83
Pharmacist, $52/hour, 5 mins = $4.33
bottle = $0.15
cap = $0.05
label = $0.20
product = $1.26
electricity, phone, rent, insurance... all fixed costs but would be part of the equation too. Let's say electricity is $300 per month, $100 for phone, rent is $2,000, insurance is $500. I'm pulling these numbers out of thin air but this is just for fun. Let's further say that your local pharmacy does 600 prescriptions a week or 31,200 prescriptions a year.  So for every prescription, the fixed cost is about $.90 per Rx. We haven't even addressed any other staff for the pharmacy, promotion, advertising, even the bag to insert the Rx, etc.

So far I've got $7.72 as just the COST for processing your prescription. Remember, the pharmacy HAS to make a profit or he/she wouldn't be able to stay in business. If the pharmacy does a lot less than 600 prescriptions a week, obviously the cost is going to go up and the mark up has to be higher. So what's the trade off? Why is your prescription $30 instead of $4? Part of it is simply the cost of doing business. But why does your pharmacy continue to stay in business? Because he or she sells something that Walmart can't... that's genuine, personalized customer service. You're only on one med. But if you were on several meds its a good bet that even when the computer picks up on an interaction at Walmart they will bypass it and you'll not be counseled at the register. But not an your local pharmacy. Maybe 90 minutes isn't unreasonable to you, nor is having to let the pharmacy know 48 hours ahead of time. Maybe $30 is unreasonable for one Levothyroxine prescription... but when you look at it, really look at the numbers involved you can see that it is much more than that. Your local pharmacy will never be able to compete with giant Walmart ON PRICE alone. If that's the only thing that's important to you, then you'll never understand the value of an educated and seasoned pharmacist.

Saturday, April 13, 2013

New Gel Stops Bleeding Instantly

A New York University student has created a gel which he says can stop heavy bleeding which could make routine bandages obsolete.

Joe Landolina, age 20, a NYU junior, says that his "Veti-Gel" almost instantly closes wounds and begins healing wounds to internal organs and key arteries.

“There’s really no way to quickly stop bleeding except to hold lots of gauze on a wound,” Landolina says. “I thought if you could pour this gel into a wound, it would solidify and stop the bleeding.”

Basically it is an artificial version of something called the "extracellular matrix," which makes up the connective tissue that holds animal bodies together. “We use plant-derived versions of the polymers that make up your skin. If they go into a wound, they build on existing polymers. It’s like it tells your body to stop bleeding.”

Read the Fox News story HERE.