Demotivational Hump Day... Physicians that Can't Spell

If you don't know how to spell it, should you really be prescribing it?

Overheard at the Pharmacy Counter

Two brothers are waiting by the pharmacy counter while their mom is shopping. They think they're out of earshot from the pharmacy crew...

Younger brother: "Your penis is small. It's like a bug's penis."

Older brother, on cell phone: "Shut up. You're an idiot."

Younger brother: "I have a huge penis. I'm like a horse."

Older brother finds something on phone: "The barnacle has the biggest penis for it's body size."

Younger brother: "No way!"

Older brother: "I found my spirit animal."

At that point the techs and I couldn't hold it in any longer. We all burst into laughter.

Get PROACTIVE or Go Home

All pharmacists will agree that they hate voicemail. Despite the recording that gives clear instructions to spell names and drug names and which number to push for refill or new prescription, prescribers just push through to start leaving a message.

So one night... late, like 11:30 in the evening and well past closing time a physician left a voicemail for FIVE new prescriptions, rattling them off one after another at cheetah speed. I had to rewind the message countless times to get it all correct. Seriously, I was on the voicemail for at least ten minutes getting it all.

Problem one: the patient is not in our database. All I have is her name and date of birth. At this point pharmacists disagree on what to do, but FOR ME, I will take the prescriptions as far as I can through the workflow process. I printed labels and the techs filled the prescriptions.

Problem two: the doctor is not in our database. I have physician name and phone number. Without an NPI, insurance is going to reject the claim once we get the insurance information from the patient. A check on our NPI database revealed nothing, as if the doctor doesn't even exist. The tech fires off a call to the prescriber and is immediately sent to voicemail, where she leaves a message explaining that we need the NPI number.

The patient called to verify that we received the prescriptions and wants to give insurance information over the phone, because, well, you know... in Snootyville the five extra minutes that would take at the register is just unacceptable. Besides, these are medications for a PROCEDURE and she needs them immediately.

In other words, the physician remembered late the night before that her patient getting a boob lift or tummy tuck needed some prescriptions ahead of time.

The tech explains the situation to her about the lack of an NPI, to which she replies, "I'm diabetic and I don't have time for this. YOU need to be PROACTIVE."

Finally the physician called back to give us the information. I was about to say something about not being in the database, but then sighed and just let it go. 

We reprocessed the prescriptions. The patient showed up for her medication and again had attitude toward us about the situation. I showed her a printout from our NPI registry that showed "NO RESULTS FOUND" when we put in the name of the physician. I then told her that being PROACTIVE would mean calling in medications way ahead of time of a procedure, NOT the night before. I further told her that we had the medications ready and processed under a discount card because we didn't have all her information. I said that this was as PROACTIVE as we could get under the circumstances.

She paid and left. An hour later she called and apologized. I guess she decided to proactively be nice to us in case she needs another procedure.

Sometimes It's GOOD to Laugh

Miss Loosey gets BOTOX!

Miss Loosey, our favorite Medicaid patient, stormed into the pharmacy the other day demanding to talk to the pharmacist.

She's upset because one eyelid is droopy. And yes, it's clearly droopy. 

"Don't you have something I can buy to put in my eye to fix this?" she asks.

This is the same woman that argued with me about a Benedryl generic for a sleep aid because it doesn't say "sleep aid" on the box.

In the land of Snootyville, physical appearance is king. Miss Loosey was convinced she needed Botox injections in her eyebrows to raise them... you know... to make her more attractive... to jump start her singing career. She paid someone here in the Tri-county area $1,000 for the injections. Obviously some of the Botox made it's way to the eyelid and is causing the droopy eyelid.

Let's ignore the fact that she's able to afford $1,000 Botox injections but can't pay for her medication. Really, just push it out of your mind. There's nothing wrong with the system.

Now, men out there... when a woman asks you if she looks fat... you do know what to do, right? Same thing here. I told Miss Loosey it wasn't really noticeable. In reality, she looks like she's been in a heavyweight fight.

I told her this is out of my expertise but that it will probably go away once the Botox leaches out of her body. I didn't want to use the words "nerve damage." I thought them, but I didn't say them. 

I'm learning to keep my mouth shut, people. There might be hope for me after all.

This is Kinda Like...

Trying to keep up with the pharmacy workflow without good technicians on Monday.

Yes, I'm sure that's it

Mrs. Baked gets Fentanyl patches every month from a pain clinic. I don't get to see Mrs. Baked very often. Mostly I see her husband, usually in the middle of the day on a weekday. I know Mrs. Baked doesn't work, you know, because of her debilitating illness which requires her to be on the patch and other associated medications for breakthrough pain, etc.

The whole point of Medicaid is to help people out until they can get back on their feet again. Or that's what I thought, anyway. With the Baked family, this appears to be taking a long time because they've been in this situation since 2008. Somewhere along the way Mrs. Baked became out of sync with when the insurance will pay for the patches and when she gets the new script from the doctor. So every month it is a fight and a prior authorization process and Mr. Baked coming down to the pharmacy every day (in the middle of the day when most people are working) to check on the status.

This month Mr. Baked is especially nervous about when he can get his wife's patches. When I inquired as to the unusual "extra" urgency, Mr. Baked tells me that they need them because they're going on vacation. Well, that's nice, isn't it? So to entertain myself further I ask: Where? O where art thou vacationing, my Lord? 

As it turns out, the Baked family is going on a cruise ship traveling to the Bahamas for two weeks. So the next day Mr. Baked comes in again and why yes, Medicaid has once again approved another thirty day supply of patches. And there, as Mr. Baked picks up his wife's patches with only a signature, I noticed two things. The first was a large Starbucks beverage of some kind. You know, the ones that cost at least $5. The second thing I noticed was that he was holding one of the new iPads that Apple company is selling.

Now I know all you liberals are just going to tell me not to jump to any conclusions. Yes, I know, it's all just in my mind: Mr. Baked works at night, that's why he's there in the middle of the day. His income is really low and with his disabled wife they qualify for Medicaid. And sure, the vacation was a gift from a family member to help them to deal with all the stress And of course, the Starbucks was paid for with a gift card from yet another generous person, and he's just borrowing the iPad from someone else.

Yes, of course. I'm sure that's it.

Demotivational Hump Day... Drug Names