TamiFOOL

Two prescriptions are dropped off for a brother and sister. Sister gets Z-pack and Tamiflu. <My eyes roll> Brother gets Tamiflu. We fill the prescriptions and have them ready to pick up.

Mom steps up to the window. She asks, "Can I get a flu shot too?"

I reply, "Well, yes, you can get a flu shot, but if you've been exposed to the flu, it's not going to help."

A funny look crosses her face. "What do you mean?"

"Your kids are getting Tamiflu," I respond. If your kids have the flu, more than likely you've been exposed to the flu too.

"Oh, they did a culture. It's not the flu."

Now a funny look crosses my face, "Why are they prescribing Tamiflu, then?"

"Good question," she says. Mom looks worried and steps out of line to call the doctor. She comes back one hour later and still wants the medications for brother and sister. I ask why and I'm told it is "precautionary." I then proceed to counsel the mom on the medication and learn that its been several days since the first symptoms and that the doctor is aware of that.

"Tamiflu should be started within two days of the initial symptoms of flu," I tell her. "You said it has been several days since the first symptoms."

Mom steps back out of line to call the doctor. Another hour passes. She returns and tells me she's still going to get the medications. The co-pay is $125 per kid. She just wasted $250.

And she still wanted a flu shot.

This is me...

When the computer system

goes down at the pharmacy!

The TMI train... All Aboard!

One time a lady presented with two prescriptions from urgent care: Flagyl and Diflucan. Normally people keep their thoughts to themselves but this lady immediately informs me it was for her "smelly vagina" -- says she got "something nasty" from the boyfriend who is "always scratching" his stuff "down there" -- she wanted to know why he doesn't smell bad too. He says he doesn't smell bad because it's not from him.

Whoo whoo! All aboard on the TMI TRAIN today! Next stop: Disinfection Station!

Glad I caught this one...

Granted, the patient is a huge pain in the ass, but she didn't deserve this...

Hydroxycut WINS over Simvastatin

Just today one of my patients chose to pay $25 plus tax for a 30 day supply of Hydroxycut, an over the counter product containing herbals for weight loss which has not been evaluated by the FDA. She declined refilling her cholesterol medication Simvastatin (Zocor) which was $10 for a 90 day supply.

Sometimes patient choices really puzzle me.

Advice for NEW Pharmacy Patrons...

If you step up to the counter and no one helps you within five seconds, do one or more of the following:

Drop your keys on the counter

Clear your throat

Knock on the counter

Rustle your purse, bag, or keys

Say "Hello Hello" because one "Hello" just isn't enough

Look around the entire store like you need help

Look around the store like you're admiring the view of the Grand Canyon. Stand on your tippy toes while doing this

Whistle a merry tune

Lift your body up and look over the counter to see if anyone is back there

Do a fake cough

Sigh loudly

If you're chewing gum, blow a large bubble until it pops loudly

Drop your purse on the counter

Drum on the counter like you're in a rock and roll band

Say "I'll call you back, I'm at the pharmacy" while holding your cell phone to your ear. If it is a flip-phone, snap it shut loudly

Have your baby make noise or start to cry

Yell out, "Is [name of the other pharmacist] here?

Walk down to the other window briskly, look mad, and say "We need some help down here!"

If another ten seconds pass, try another item from the list above. If that doesn't work, immediately get a manager from the grocery. There's absolutely no reason why you should have been made to wait a minute or two.

Attention Readers

I need some time away from the blog for personal reasons.

Thanks for your understanding.

Blank Script | Taylor Swift "Blank Space" Parody

OMGosh... I have patients exactly like this!

This is me...

Talking about how things work in

Retail Pharmacy on Monday morning...

Let's Open Crazy RxMan's Photo Album...

...and see what's inside...

And now you know WHY

I am the Crazy RxMan!

The Pharmacist has ULTIMATE POWER over TIME and SPACE

Or at least some people think we do.

Consider if you will the story of Mrs. Advent, one week away from needing her Advair and Ventolin inhalers. Now I suppose you can't fault her for wanting them filled today, except for the fact she's already on Automatic Refill and we always have it ready for her in advance.

No, she wants them right now.

Aladdin the tech sends a claim. "Coverage Terminated as of 12/31/2014." He tells Mrs. Advent the results.

"No. It's not terminated."

Aladdin rubs his magic lamp again. No Genie. He tells her she must have a new card or a new ID number.

"No. It's the same number and still active. May I please see the pharmacist?"

He comes to get me. I was actually doing something important but Mrs. Advent needs to speak to me, immediately. By all means, let's distract the pharmacist while he's dealing with medications that save people's lives.

I step up to the window. Mrs. Advent starts by telling me about her asthma condition and that she can't be without her medication. Let's see, I've been filling for you for YEARS and you think I didn't know you have asthma? Really?

Then she tells me that the technician doesn't know what he's doing because her insurance information hasn't changed. She's sure that if I step up to the computer and process the claim, I will be able to use my almighty power over the heavens and earth to get it through. 

I'm up to the challenge. I send off the claim...

"Coverage Terminated as of 12/31/2014."

Now of course I have to tell her all the same stuff Aladdin already told her about her insurance. I even told her we'd be happy to call and confirm that information... AFTER we're caught up on the current SNAFU at present in the pharmacy.

Mrs. Advent gets upset and once again tells me she can't be without her medication... 

Thanks for that, I completely forgot what you told me like three minutes ago.

...in a week or so, because she's really not out yet. We're pre-emergency right now, and that's almost like an emergency when you're asthmatic.

I assure her that no matter what happens we won't let her go without her medication. I tell her to go home and relax then call her insurance and find out her new information. She agrees that she'll call the insurance, but only to find out why it's not working today or what we've done at the pharmacy to keep it from working.

The next day...

In walks Mrs. Advent. She called the insurance which told her about the change that was made and that they sent out new cards in late November. Fortunately she didn't throw away the envelopes and has the info for Aladdin to process.

He puts in the new info... sends off a claim...

"Claim Denied. Prior Authorization Required. Step Therapy Required."

He tells her the bad news, but because she's been on the medication for a long time her doctor will be able to call her new insurance and straighten it out, no problem.

And of course... she's NOT satisfied... and she asks...

"May I please see the pharmacist?"

Euthanize Me!

The Magic Insurance

Some people have magic prescription insurance. They don't need to know what it is to get their prescription filled... because IT'S MAGIC:

Lady comes in with a new prescription...

"I want to get this filled..."

Really? I thought you were going to make a paper airplane out of it. Seriously, we know the routine. You don't need to tell us that.

"...and I have new insurance..."

These words cause every pharmacist or pharmacy technician incredible dread and despair.

"...but I don't have the card. I called and they gave me my ID number and told me to tell you it is Well-I'll-Be-Healthy-Net."

Great. Well-Net has like 173 different combinations, all with different BIN, PCN, and group codes. The menu choices at Cheesecake Factory is smaller.

That's nice that you have your ID number. But did they give you the BIN, PCN, and Group?

"Oh, oh, group! Yes, it's GOLD group!"

This lady honestly thinks at this point we have EVERYTHING to process her prescription. What an L7 weenie!

"And what about the BIN and PCN?"

<blank stare> Her eyes glance over to the computer, and then she says the magic words...

"Can't you just look it up?"

I refrain from throwing my lab jacket on the floor and shrieking down the aisle as I leave this God-forbidden business known as retail pharmacy. This is it! I can't take it anymore! Run, Crazy RxMan! Run! Get out! Get away from this place, burn it to the ground, and never look back!

I respond, apologetically... "No."

Somewhere, somehow, I know Babe Ruth is disappointed in me.

I ask a technician to take a look at the situation while I go to counsel a lady with questions about her vaginal discharge. What a fun job. Yep, Forbes was right, this IS the job you want, people.

The tech spends THE NEXT 30 MINUTES on the phone with The Beast (known as Well-Net) trying to track down the lady's billing information. While the tech was on the phone, I had another tech at lunch, and the gods decided this is THE half hour of the day when 22% of the day's scripts would be filled, which ALL fell on my head. I was busier than Squints checking out Wendy Peffercorn on a hot summer day!

PEOPLE, for the love of all that's HOLY, please, please, please get your complete billing information from your insurance BEFORE you come to the pharmacy!

By the way, The Sandlot is on the RxMan's list of the top five movies of all time. Here's why.

Unhappy about Anything, Anywhere? Just Call Us!

We're busy. It gets like that. And when it happens, that's when the most interesting things happen...

<Ring> <Ring>

Al the magic tech answers. I overhear one side of the conversation:

"Thank you for calling Goofmart Pharmacy, where it is not too late to get a flu shot. This is Aladdin the magic tech, how may I help you?"

<pause>

"Well, I know pharmacies do get very busy. Right now we're pretty busy..."

<pause> Al has been cut off.

"Well, I'm sure there is..."

<pause> because he's been cut off again.

"I don't know what I can do...

<pause> cut off again... listens another 30 seconds, then Al hangs up.

Al didn't say "Be Swell." I make a mental note to write him up about that later.

"What on earth was that about?" I ask, having lost five minutes of precious tech time during the phone call. In pharmacist time, five minutes equals a lot of pharmacy work lost to oblivion.

"That was one of our regulars. He's on the other side of town and is getting his prescription filled there. He called us to ask why that the OTHER pharmacy is taking too long."

Al explained more of the phone call: the OTHER pharmacy is not a Goofmart Pharmacy. This guy was upset because he wasn't getting his Rx filled as fast as we do it and called us to complain about that and wanted us to call the OTHER pharmacy and tell them to go faster.

And no, we didn't call the OTHER pharmacy.

Funnies for a Snowy Sunday

Opening Your Own Pharmacy?

I don't recommend naming your pharmacy anything below:

Potions for the Impotent
PEG's Solutions
Reich Aid Pharmacy
Careless Compounds
ED World
Hormones-R-Us
Trader Victoza's
Statin Station
Rx Dude
Side Effect Ceuticals
Leon's Creons
Zonegran Zone
Pla's Cebo Pharmacy
Ready-Tomorrow Pharmacy
Pharmaturd's
Guy's Nocomastia Emporium
Lipitor Lobby
Vico Den
In-and-Out Pharmacy
Spartan's Sartans
Pharmacialis
Crazy RxMan's

This is me...

Trying to get out of the pharmacy on a busy Monday...

Your kidding, Right?

The last tech leaves for the day and I'm left to face the rest of Monday alone. It was particularly brutal this Monday and I'm tired, sore, and burned out. Did I mention I was tired?

7:00 pm ~ Mr. Kripp, a regular of ours drops, off four prescriptions, including a C-2 which requires special handling at Goofmart Pharmacy. I tell him 20 minutes when I really needed 40 minutes. I have a mother lode of work to catch up on and four transfers as well.

7:08 pm ~ Mr. Kripp walks up to the counter and asks if the prescriptions are ready to pick up.

I'm without words. Seriously. What color is the sky in Mr. Kripp's world?

I really hate Mondays.

Rejected Names

2015 is the year many of the new drug approvals in 2014 will hit the market. The naming of these new drugs is part of the process. Following is a list of rejected names for these new drugs:

Top Ten Recently Rejected
New Drug Names: 

1. Nasalbleed 
2. AnuDry  
3. Bluestical 
4. Gabawreck 
5. Dungsoft
6. Lackfective
7. NoBoneratall
8. Prowart
9. Painalot
10. Costoomuch

Valium is Funny

"You need to smell this," she said.

She is "Foil Hat" lady. That's what the techs call her now ever since THIS happened. We were calling her Iron Maiden for awhile because of a run in we had with her over some iron supplements for her father (See THIS and THAT). But after a few other incidents with her, Foil Hat Lady seems to stick. 

Foil Hat Lady has her arm stretched out, trying to hand me an empty bottle of Valium. This is one of our very select, special patients that must have brand Valium and must have it in the original container. But today's she's upset because the bottle of Valium "smells funny."

I take a big whiff. The tech takes a big whiff. Neither of us can detect anything out of the ordinary, and I'm the kind of guy that knows when a baby needs a diaper change at the other end of the grocery. We both tell her that we can't smell anything unusual.

Foil Hat Lady rolls her eyes. "It's FUNNY," she says, then starts looking at me like I'm going to do something about it now that she's pronounced judgment. I really wanted to make a joke out of it, like saying that she smells funny but I don't hold it against her... but I'd get fired for that.

I also thought about asking her if the bottle of Valium is telling jokes now. It seems reasonable... take enough Valium and it starts telling you jokes. Heck, it might even have that listed on Up-to-Date as a side effect.

"Well, I can't smell anything unusual," I reply. I'm really curious at this point what she expects me to do since she's consumed an entire 100-count bottle of Valium and is only now concerned about the smell. So I'm silent.

"I guess I should call the manufacturer..." she says, finally.

Inside I breath a sigh of relief. This is quickly turning into someone else's problem and I'm elated. The circus is leaving town and I didn't have to deal with the monkey, the bull is in another pasture, Elvis has left the building... well you get the idea.

The Irony of The Authorities' Inventory Management

So late in November we had one of those Mandatory Conference Calls. I had to get up early to get down to the pharmacy so I could get in on the call. That annoys me. I'd rather be sleeping.

One of the things that The Authorities spoke about... no, that's too kind. We were MANDATED to reduce our inventories by the end of the year. Accountants in the company want to close out the books with low inventories. Yes, I'm sure that $200,000 in inventory looks sooooo much better than $210,000, right?

Well, ok, Mickey the pharmacy manager and myself started watching things closely to snip off a few hundred dollars here and there. Sure, we had to turn away some patients because we didn't have the medication in stock, but that's inconsequential to inventory management, right?

Pretty soon it added up and we were able to reduce the inventory by about $5,000 by the middle of December. Hey, it wasn't much, but it I'm sure it made some bean counters in the company very, very happy.

And then it happened...

One day in the middle of December, and as irony would have it, during the overlap time between me and Mickey, here comes the UPS dude. He has one of those giant Styrofoam shipping containers. You know the ones... the ones that make you sick to your stomach when you see it because you know it is full of vaccinations of some kind. It's even further ironic because Mickey and I were talking, at the exact moment the UPS dude walked in, about the good job we had done reducing the inventory.

Our mouths dropped. We were stunned. The tech signed for the package and opened it. There inside were not one, but TWO boxes of expensive Zostavax, sent to us by The Authorities... the very Authorities that made us come in early that one day just a few weeks before to nag at us to REDUCE the inventory! Now here they are increasing it dramatically with two tiny boxes, uprooting and destroying all the work we put in to lower the inventory.

Now, are you ready for the BEST part? Ok, ok, hold on to something... this one will knock you out of your seat. The Zostavax shipped to us expires in the middle of January, 2015!

If after everything you've read that I've said about The Authorities over the years hasn't convinced you that I work for a bunch of imbeciles, I've finally got you. This is it. There's no denying it now. These people have absolutely no brains of any kind and here they are in charge of healthcare?

It's a NEW Year. Let's Laugh!