This lady drops off a prescription. The entire time she's on her cell phone. I think it might actually be glued to her ear. Because she's on the cell phone she didn't hear me tell her it would be a 15 minute wait. She just stands there in the middle of the aisle staring at me while she's talking on her Borg implant. She's no where near our drop off window or pick up window or "wait here for patient privacy" sign. She's just out there, in the open, yapping away and staring at me. I fill her prescription quickly because I can tell she's a potential complaint and gift card candidate. I finish filling the prescription and start heading toward the register. Another lady walks up to the pick up window (after all, no one is standing there, and from her perspective it is completely reasonable to expect that she's next in line). You would think the Borg lady wouldn't have an issue. She's been told it is going to be 15 minutes and I'm clearly way under that, she's on some important call talking about who knows what, and she'll be out of here lickity-split, right? No. She belts out at the other lady, "I'm next! I've been waiting in line!" all the while plastered to her cell phone. The other lady looks at me, looks around, can't figure out how she cut in line (when she actually didn't) and sheepishly apologizes and moves aside. I check out the Borg witch. I try to counsel her on the medication. She pretends to hear me with fake nods. She walks off, still embroiled in her conversation. All I can do is shake my head. There are no words.
The regional pharmacy manager paid a tech to spend the entire day on Sunday getting the pharmacy in order for the more corporate visitors coming next week. Part of that reset was redoing the OTC items. The tech followed a planogram exactly which told which product was to be where, exactly, on the shelves. Then the grocery store manager came in on Monday morning and spent the ENTIRE morning resetting it the way HE wanted it, not only ignoring the planogram from corporate, and despite us telling him that the RPM wouldn't be happy with it. The store manager didn't want to listen to us.
When I arrived at work that afternoon, the RPM showed up as well. He ignored all the hard work that the Sunday tech performed all over the pharmacy, instead focusing on some really unusual things deemed vital to change. For example, some items posted on a cork board weren't aligned perfectly horizontal. And then he saw the OTC items and how they didn't match the planogram, at all. By his reaction you'd think we'd killed a child or something else horrible. There was nothing we could do. We had to blame it on the store manager or the tech would have been in trouble. The next thing I know the store manager and the RPM are working side by side in the pharmacy while we're trying to fill prescriptions. They spent at least two hours resetting the products BACK to match the planogram. Can you imagine all the time, money, and resources wasted here over NOTHING except to impress some corporate managers? Such mismanaged priorities. Seriously.
Ms. Waldo hands me a prescription from her dentist. It's for Percocet 5/325, quantity 30. "Does the dentist know you're taking Oxycodone?" I ask, knowing that she gets 30mg, quantity 150, every month. "I don't know," she replies. "Is there a problem?" "This likely won't go through on your Medicare insurance because you're already taking Oxycodone 30mg several times each day," I reply. Somewhere, somehow, I know @PharmacistSteve's ears perked up. "Yes it will! This is from my dentist! My Oxycodone is from my physician!" I'm amazed at her expertise so I try to process the claim. Medicare kicks it back with a message about exceeding recommended quantity limits. "As I feared, Medicare won't pay for it. I can try our in house discount and see..." "UNBELIEVABLE!" she retorts. A guy over by the eggs on aisle five turns around, shocked. "Why?!" "You're taking five tablets of 30mg Oxycodone every day. The additional Oxycodone in the generic Percocet will push you over their daily limit of Oxycodone in a patient your age. Besides, it really isn't going to help that much..."
She cuts me off. "UNBELIEVABLE!" The guy over at the eggs hears it again. Apparently this scared him because he rushes off. And all I can think about is the guy from The Princess Bride. "What do you mean it isn't going to help?! This is for my dental pain! My other tablets are for my back pain," she says, angrily. "You're taking 150mg of Oxycodone every day. An extra 5mg to 15mg of Oxycodone in the Percocet each day isn't going to help much. Your pain will be addressed by the..." She cuts me off again, "UNBELIEVABLE! How do you explain that this Percocet is helping me?" "It's probably the Tylenol in it. Tylenol is great for mandibular pain." "NO! Tylenol doesn't do anything for me! It's a different kind of Oxycodone." Yes, fans, with God as my witness, that's what she said. It's a different kind of Oxycodone. All those years of pharmacy school. Thousands of dollars of tuition being paid back and I missed that lecture. I feel cheated. "No, it's the same Oxycodone," I state. You'd think I'd know since I'm the pharmacist. It says so on my name tag. "UNBELIEVABLE!" she spits out again. Reluctantly, she accepts the discounted cash price. Reluctantly, I dispense the 15 tablets of generic Percocet: the one with the different kind of Oxycodone in it.
If you're a pharmacist or pharmacy technician, you probably have one or two friends who are also patients of the pharmacy where you work. This creates awkward situations in a number of ways. First, you know about your friend's conditions and treatments which might be embarrassing. Second, because of your friendship, sometimes you're expected to do things you wouldn't normally do. For example, I've had friends expect me to: * Give them early refills on narcotics * Give them a discount on their co-pay * Authorize a refill request without actual prescriber approval These are things that a friend shouldn't ask for because they are a friend! When someone asks you to put your job in jeopardy for them, that's asking too much. You could always try to keep a little humor in it and present them with this card:
How do you handle it without straining the friendship? What seems to work for me is to simply tell the friend "I wish I could, but this could be big trouble for me." If you take the time to explain that pharmacy has a set of rules which are strictly watched, your friend should understand. Unless they're not a real friend.
A few years ago we had a major remodel to the pharmacy. The layout of the pharmacy was completely changed and as a result it became a race track with a huge number of added steps to perform the same simple tasks. And when I say "steps" I'm being literal. It requires a lot more footwork to do the same thing. By our calculations it now takes at least 30 extra paces to go to will call and check out a patient on their medication. Don't worry. We can handle the extra physical work. But when the RPM first came by to inspect the remodel, pharmacy manager Mickey told her that it is a lot more work, step-wise, to get a patient out the door. I was there and witnessed the conversation, and what I'm about to tell you is absolutely true: The RPM insisted that there are no extra steps with the new layout. She was completely adamant that no extra pacing was involved. So Mickey goes to the filling station and starts counting as he walks to the will call and then to the register. "See?" he says to her. "That's at least 15 extra steps from the old layout."
Ahhh, but Mickey was not aware that the RPM (and apparently all Goofmart Authorities) must have complete control over time and space. They have Q's ability to manipulate the very fabric of the universe. For were that not true, there would be no way she could make her reply statement: "No, that's wrong. It's not any more steps than before the remodel." She said this just after he paced it out and counted the steps for her. Obviously, Mickey was unaware that the RPM was controlling time and space, and had it completely wrong. But somehow I doubt Goofmart Authorities can control time and space. They seem to be unable to tie their shoelaces most days. Maybe there is a simple explanation. Our RPM must have been well aware of Zeno's Paradox. That's the only way she could have made her claim. "Why there's not any extra work involved with this remodel! Oh, no, you're wrong! You never actually made it from the filling station to the register? Why? Because you had to first go half the distance to the register, and then half of that, and then half of that... etc., etc. ~ ergo you never actually made it to the register therefore your claim is invalid!"
But people seem to get where they're going all the time so it can't be that. The third possibility is that our beloved RPM was just repeating a canned answer thought up by upper managers in the ivory towers to address the simple questions by such simple idiots... you know, us pharmacists in the trenches. Instead of admitting to anything, just tell them they're wrong. Thirty extra steps? No. You're wrong. And yet these people want us to trust them when they tell us they're doing all they can to get us more tech hours. Really.
Technology is great. It helps us in ways we never dreamed possible. Can you imagine the ability to simply send a text message to get a pizza, confirm a dental appointment, or even get your medication refilled 20 years ago? Nope. If it was around then it was very limited. And now there's PHEXTING! It's using texting to order refills on your pharmacy prescriptions. It's just GREAT!
But along with that comes a whole new set of problems. Every day we get some goofball at the pickup window and this is how it plays out: "I'm here for my prescription. I got a text saying I have a prescription ready for pick up." We go to the will-call shelf. Nothing is there. "What did the text say?" we ask. "I don't know." "Did you read the text?" "Well it says something about a prescription." "Does it say It's Time to Fill Your XXXX.Please reply with an F to fill." <Looking Sheepish> "Yeah, maybe. I don't know." "That text is telling you it might be time to fill your XXXX and if you want to fill it to reply with an F for FILL." <Looking impatient> "Well is it ready?" "Did you respond with an F to fill it?" I know they didn't but I'm trying to get the neurons in the patient's brain to connect this all together for next time. "No. Maybe. I don't know." So much for that. "We don't have it filled so you must not have responded to the text. I can get it filled now. It will be about 10-15 minutes." "Oh wow, that long? What's the point of having the text thing then?" <sigh> Euthanize me.