Wednesday, April 30, 2014

Crazy RxMan's Best Tweets of 2013

In case you didn't know, Crazy RxMan is on Twitter as @CrazyRxMan. You're probably already aware of that, but if you've always looked at this blog via a mobile device, the latest tweets box might not show up on there.

Here are the most popular tweets from 2013:

Good techs are worth their weight in GOLD! THANKS to all you techs out there making life easier for pharmacists and patients! I SALUTE YOU!

By the end of my shift I hate everything pharmaceutical, people, and most anything within eyesight. That's normal, right?

Hey PRESCRIBERS, how about you STOP giving drug coupons to patients on Medicare. They CAN'T use them and WE have to give them the bad news.

You tell me you don't want a flu shot because it will give you the flu. I hate you.

Isn't it amazing how "Grandma" doesn't care about what insulin syringes she gets... any of them will do... ???

You would think people would be patient with the pharmacy considering we handle meds that could make their life miserable if missfilled.

"Oh no, I don't mind leaving my lunch to answer a question on your bowel movements... not at all."

I weep for our children's future. The vast majority of the public is so amazingly stupid it's no longer funny-- it scares me to death.

No, we don't stock every pharmaceutical product known to man. NO ONE DOES. Deal with it.

~> Pharmacists! Buy your technicians lunch on occasion. They deserve it.

Tuesday, April 29, 2014

Read My Mind, Pharmacist!

Patient calls on phone and demands: "Fill my orange tablets," adding, "I'm out of them." 

The patient comes in, opens bottle, says, "Why did you fill these?"

"You said the ORANGE ones!" I replied.

"No! That's what I said but I meant the white ones!"

Monday, April 28, 2014

The Mishaps of Medicaid Man

Medicaid Man went through a month supply of Percocet in about 23 days. He saw his regular pain management doc and was given a script which we filled later that day. It was unusual for us because most people on a pain medication want to wait and stare at us until it is finished. Medicaid Man left and came back later. It doesn't matter to Medicaid Man because not only does the state pay for his doctor visits and medication, they also pay for a cab to drive him around to these appointments.

Yesterday Medicaid Man was here with a script for Vicodin 5/300 from the 'Mergency room. I told him I could have it ready in a few minutes (I was thinking I could save the state and our tax dollar by squeezing this into one cab ride), but Medicaid Man didn't want to wait. A few minutes after he left, I processed the claim and it was rejected. Medicaid doesn't want to pay for the expensive 5/300. So I try to call Medicaid Man to keep him from coming back. I want to tell him that I'll get it straightened out the doc and not to come down again, but Medicaid Man doesn't answer his Obama phone.

So later in the day I have to give him the bad news. He took it well. I told him I'd take care of it tomorrow and he'll just have to wait. He seems ok with that. Off he goes for another free cab ride... free to him, paid for by all of us.

That was yesterday. TODAY here he comes again. He visited the 'Mergency room again last night and they gave him a script for Percocet. This time I won't let him leave. I process it and babble-ba-zoo, there it is, a REJECT. You see, it's only been 23 days since he obtained his 30 day supply of Percocet. Medicaid doesn't want to pay for it right now.

So just to keep track... since 23 days ago... we've had two visits to ER and six cab rides, ALL of which were tax-payer funded. The patient has yet to get any pain medication due to the government "cost containment system" that is just working so well.

If this was just ONE example, sure... we could just let it go. But it's not. Things are out of control people. Time to wake up.

Saturday, April 26, 2014

This is me...

... on a Monday morning at the #Pharmacy ~ but instead of packages of food, imagine these as prescriptions:

Thursday, April 24, 2014

An Awkward Moment

A lady comes up to the counter and asks me if I can help her with something embarrassing. Sure, I tell her, I'm here to help. Secretly I'm cringing...

She tells me that she is from out of town and brought her Premarin cream but forgot the applicator. For those who don't know, this cream goes in the vagina and that's why it is embrassing to talk about. I tell her I don't have extra applicators but that maybe I have an idea...

Before I have a chance to say anything, a guy walks up and asks me where the bathroom is located.

I'm always stunned when people do this. I have about TEN signs about patient privacy. And despite that, it's just rude to interrupt. Were you born in a barn, for Pete's sake?

It was already an embarrassing subject and we're already whispering. I'm doing my best to protect this lady's privacy about a sensitive subject when this jackass interrupted.

"I'll be with you in a moment. I'm helping this lady right now," I said. I said it with a tone. I had a tone.

"Oh, I'm sooooo sorry," he says with sarcasm. "I didn't mean to overload your brain with such a hard question," he replies, walking off. And now you know why I call him a jackass.

"I'm sorry," I said to the lady. "Maybe you could use this dosing syringe as an applicator. Just clean it with alcohol first. Sorry about that guy."

"Oh, that's ok. He's my husband."


I'm sure glad I said "sorry about that guy" instead of "sorry about that jackass" (which is what I wanted to say).

Wednesday, April 23, 2014

The Entitlement Attitude Continues

There is a shift taking place in our society. As more and more people shift from being productive members of our society to ones who depend on the working class for their welfare and medication, an attitude is beginning to surface. The attitude is very strong among people on Medicaid in my area, and every year I see it getting worse.

Case in point:

A new prescription for a patient comes in via e-script. We attempt to adjudicate a claim to our state-funded Medicaid program. It returns a rejected: NDC not covered. I'm not surprised. It's for Restasis. The rejected claim also says something about using the OTC product Artificial Tears.

As a courtesy to the patient, we fax over a "prior authorization" form to the doctor. Maybe the patient already has a failed history of using Artificial Tears, or perhaps there is another reason the patient must have Restasis. Who knows? But at this point the only way the claim will process is after the doctor calls the insurance. I've seen $1.50 aspirin covered by Medicaid. I've seen Accutane covered by Medicaid. Maybe they'll cover this one?

The patient shows up. We tell her the situation about the prior authorization and how we're waiting to hear back from the doctor. Whoosh. She didn't understand.

"But my doctor authorized it. He wrote the prescription!"

I try to explain again, this time going from start to finish. I have a whole little spiel for people unaware of what "prior authorization" means:

"When we sent off your prescription electronically for payment, your insurance asked for a 'prior authorization' because this medication isn't on your insurance's list of medications they pay for. This means the insurance wants to talk to your doctor before they will decide whether to pay for it or not. We have faxed over the forms to the doctor and we're waiting to hear back now."

I've said this so many times over the years it just rattles off my tongue now without even thinking about it.

"I'm going to call my doctor! He wrote the prescription! Didn't you get a prescription? He authorized it! I'll call him right now."

I ask the tech to give the lady the prior authorization form. I tell the tech the lady is going to handle it now. The lady takes the form, moves to the side of the pharmacy, and pulls out her Obama cell phone to call the doctor.

She starts talking to the office staff. I didn't pay much attention to what she was saying, but I did hear her say the following:

"I'm here at Goofmart Pharmacy surrounded by a bunch of retards."

I look at the tech and ask her, "Did I just hear her say what I think I heard her say?"

Yes I did, she tells me.

And there you have it, folks, more of the entitlement attitude I'm talking about. Here's what we've learned today:

If you're on Medicaid:

1. When the doctor writes a prescription, it should ALWAYS be covered simply because he/she wrote a prescription.
2. Cost containment policy and procedure doesn't apply to you.
3. If the pharmacist and technician doesn't understand 1. or 2., they're "retards."