Thursday, August 20, 2015

Trying to be Nice has a Price

Red is a patient of ours. He normally calls about 5:30pm, tells us what he wants filled, and then says he's on his way down. Or he just shows up with a new prescription and tells us he'll be back in a few minutes. Most of the time he's been lucky and there's been enough of a break to actually fill his prescriptions before he gets back to the counter with several quarts of ice cream and our store brand Salisbury steak dinners. If we don't have his prescriptions quite ready, he's patient but obviously unhappy. He acts like our pharmacy is only there for his prescriptions, but he's always gracious and friendly.

Red is also the only patient I know who smells like he smokes about twenty packs a day. He's also the only patient I know that has managed to go through a prior authorization process to get Frova approved to take on a daily basis. I don't know exactly what happened with Red, but he was diagnosed with cancer and is now going through heavy chemotherapy treatments. The treatments are extensive and he's had quite a bit of nausea based on the medicine he's been prescribed and shown up to have filled in five to ten minutes.

Red has suffered some extensive skin damage to his neck and chin. It's bright RED. And I assume the damage is on the inside because he's gone through several prescriptions of "Magic Mouthwash," a mixture of Mylanta, Benedryl, and Lidocaine. Two days ago Red showed up again at 5:30 with yet another prescription for Magic Mouthwash. Unfortunately, we didn't have any Mylanta in stock and there was none on the grocery aisle either. It's like all the Mylanta (and generics) just suddenly disappeared off the planet for some unknown reason. I informed Red of the situation and that I'd order some directly from our supplier and we'd make it up for him the next day.

The next day I was dealt with another blow. Mylanta (or a generic) was not in our order. Our new supplier is lightyears behind our old supplier (but that's another story) and it was not in the order despite the fact I had a confirmation for delivery. The clock ticked and I wasn't sure what to do.  No new Mylanta showed up in the grocery, so I sent my tech across the street to our competitor where she purchased some of their store brand generic Mylanta with MY MONEY. I didn't want Red to suffer, so this seemed a reasonable alternative.  I made the compound and Red picked it up, along with his usual odd assortment of grocery items because he just can't handle the self-check out up front. That was yesterday.

And then there was today...  Red's doctor called and began berating me for doing the compound wrong. He said it didn't taste the same nor did it work the same and that he was going to call the manager, the store manager, our chain manager, the President, and God himself to complain about the botched compound. When I tried to explain that the compound was made using another generic Mylanta and that likely changed the taste, the doctor would not hear of it. When I asked if maybe the chemo-induced damage to Red's throat might have made the medicine seem less effective, the doctor would not hear of it. The call ended with the doctor hanging up on me with all the threats still up in the air.

So there you have it, folks. Spend your own money and try to get your patient the medicine he or she needs and your butt reamed in the process. And I assume the President will be calling any day now to complain about how I "botched" this compound.


Texas Pharmacy Chica said...

Yeah. I have had that happen, too. Except it was a child on hospice and that competitor pharmacy had used lemon flavored Mylanta with the Benadryl. Parents were relieved to hear we had cherry flavored generic Mylanta which did not clash with the (always-)cherry flavored diphenhydramine. Heartbreaking, right? Years have passed since then and I still don't let the techs order in lemon flavored Mylanta or its generics for the compounding area.

No mylanta shortage - but some of our MMW recipes use tetracycline and that is still not available. But somehow, they still make Savella which is marginally useful.

Anonymous said...

Patients don't care what nice stuff you do for them. They care about getting what they want.

sconesail said...

Thanks for reminding me just how much pharmacists do for their patients. I have intractable migraines and a fainting disorder for which I have to take several medications. Two recent incidents have shown me just how great a good pharmacist can be.

A few weeks ago, I was just coming back from a trip and the pharmacy was closing. I would have understood completely if the pharmacist had chosen to tell me to come back the next day- but he didn't. He ran back into the pharmacy area and grabbed my script. I thanked him profusely.

About three weeks ago, When I went to pick up a script, the pharmacy was locked. It turned out that the on-duty ppharmacist had a family emergency and the only key to the pharmacy part of the store. The techs took names and called us when it was ready.

So thank you for all that you do for us. It is much appreciated.