Thursday, February 27, 2014

Let ME Speak to the Pharmacist

It happens every day.

Ring... ring... ring...

Tech answers phone, "Thank you for calling Goofmart Pharmacy. This is Super Tech. How may I help you?"

"I need to talk to the pharmacist."

"Please hold for a moment."

Super Tech tells me that I have a phone call waiting.

"Hello, thanks for holding, how may I help you?"

"Yes, I need a refill. The number is 7939439."

Every damn day.

ATTENTION PATIENTS: You do NOT need to talk to the pharmacist to order a refill on your prescription. You can ask anyone who answers the phone. You don't even need to talk to anyone. You can use your phone's keypad to enter the prescription number. You used that same keypad to phone the pharmacy so I know you know how to use it.

You DO NOT need to talk to the chef to order a steak. You know this. You DO NOT need to talk to the Doctor to make an appointment. You know this. You DO NOT need to talk to the cab driver to get a cab. You know this.

So WHY do you think you need to talk to the pharmacist to ask for your refill? Why? Why? Why?

Wednesday, February 26, 2014

Top Sales in 2013 ~ by Sales

Top Sales by Retail Price

1 Oxycontin 40mg
2 Advair 250/50
3 Nexium 40mg
4 Crestor 10mg
5 Celebrex 200mg
6 Aciphex 20mg
7 Lantus 100U/ml
8 Exalgo 16mg
9 Lidoderm 5% patch
10 Androgel Pump 1.62%
11 Provigil 100mg
12 Cymbalta 60mg
13 Abilify 5mg
14 Solodyn 55mg
15 Oxycontin 20mg
16 Spiriva Handihlr
17 Frova 2.5mg
18 Viagra 100mg
19 Asacol HD 800mg
20 Zostavax

*Interesting note... we have ONE patient on Exalgo 16mg and ONE patient on Frova 2.5mg. Both patients had an extensive prior authorization process (see PRIOR AUTHORIZATION). As mentioned, the Frova represents ONE patient, but he takes it every single day. How a prior authorization for this was obtained I'll never know. Exalgo is hugely expensive and she gets large quantities paid for by Medicaid at taxpayer expense. 

Tuesday, February 25, 2014

Top Sales of 2013 ~ by units

Top Sales by Units in 2013

1 Oxycodone 30mg
2 Endocet 5/325
3 Oxycodone/APAP 5/325
4 Hydrocodone/APAP 10/325
5 Tramadol 50mg
6 Zolpidem 10mg
7 Carisoprodol 350mg
8 Metformin 500mg
9 Oxycodone 10mg
10 Butalbital/APAP/Caffeine
11 Lisinopril 10mg
12 Gabapentin 300mg
13 Lisinopril 20mg
14 Oxycodone 15mg
15 Metformin ER 500mg
16 Alprazolam 0.5mg
17 L-Thyroxine 50mcg
18 Lovastatin 40mg
19 Sertraline 100mg
20 Alprazolam 1mg

Compare to Top Drugs of 2012 and Top Ten Profitable Drugs of 2012

Monday, February 24, 2014

Top Sales of 2013 ~ by Number of Rx

Top Sales by # of Prescriptions

1 Zolpidem 10mg
2 Fluvirin 2013-14
3 Azithromycin 250mg Z-pack
4 Fluticasone 50mcg
5 Oxycodone/APAP 5/325
6 Simvastatin 40mg
7 Montelukast 10mg
8 Carisoprodol 350mg
9 Amoxicillin 500mg
10 Fluzone HD 2013-14
11 Simvastatin 20mg
12 Sertraline 100mg
13 Lisinopril 10mg
14 Lisinopril 20mg
15 Tramadol 50mg
16 Hydrocodone/APAP 5/500
17 L-Thyroxine 50mcg
18 L-Thyroxine 100mcg
19 Cephalexin 500mg
20 Amoxicillin/Clav 875

Saturday, February 22, 2014

Wow! Cool Transformation Video!

The special effects in this video are pretty cool:

The song, which is sung in French, starts with a list of brands and designers such as Prada, Hugo Boss, Chanel, Giorgio Armani, and  Lancome, before moving onto the refrain which states, ‘I am not a product.’

The chorus declares ‘Of beauty, preciousness; they cannot change me. Peerless, unparalleled. The new fragrance is myself’ while the third verse states ‘mascara, blush, lipstick, lipsticks, lip liners, eye shadow, foundation, nail, pressed powder and I do not want it.’

The video, which has exploded across the web since its release is part of a trend attempting to lift the lid on the lack of reality in celebrity culture and advertising. 

Friday, February 21, 2014

GADGET FRIDAY: Pill Reminder

Staying on a good regimen of vitamins or needed medical prescriptions can be very difficult. It’s one more tiny thing to remember in a day, and while taking it with breakfast seems like a great idea, there are always those days we skip eating because we’re running late. Usually one of the last things you do before running out the door is brushing your teeth, because no one wants to sniff on some bad breath.

Instead of putting your pills next to your toothbrush, why not rig it so that your toothbrush will remind you to take your meds? The Pill Reminder is a simple idea, and might just make your life a lot easier. This system places your prescription behind your toothbrush, and as you pull your toothbrush away, your pills will pop up and that will act as your reminder.

There are of course, a few issues with this system. Even though it’s easy to install, it does have a size limit for both the handle of the the toothbrush and the container for the pills. That being said, you’d have to spend $27 on this contraption, and more on a different container that will hold your pills if they’re loose. Another problem is that not all pills are tiny, and if you have to take medicine that looks as though it was actually intended for a horse, it’s certainly not going to work with this. While it’s a swell idea, it is a bit of a niche product as it’s not going to suit everyone’s needs.


Thursday, February 20, 2014

Keep to the Code

If you're a new pharmacist, you're probably unaware of The Code

Yes, pharmacists have a code of conduct. This isn't the same as the Pharmacist Oath. The Code has never been written, but I'm going to spell it out for you here. If you're a new pharmacist or a floater pharmacist, KEEP TO THE CODE.

The Pharmacist Code
~ Keep to the Code ~

1. Never leave work for another pharmacist to do. If you're not going to be back in the morning, stay late and finish all prescriptions remaining. If someone is coming in at 2pm and you're leaving at 3pm, don't leave work for the incoming pharmacist to do when he or she gets there. This includes transfers, retrieving voicemails, and filling scripts. If there is something that just has to be left for someone else to do, leave a note explaining WHY it must be done that way.

2. Never blame a pharmacist for a mistake, and never point out a mistake that doesn't matter. If you discover a mistake that doesn't matter legally and causes no harm to the patient, don't make a big deal out of it. Fix the mistake and let it go. If you cover for someone today, someone will cover for you tomorrow. No matter who made the mistake, always use the word "we" when talking to the patient or the patient advocate.

3. Be on time. If your shift starts at 9am, BE THERE before 9am. If your shift starts at 2pm, BE THERE before 2pm. This is the courteous thing to do for your fellow pharmacist. 

4. Cover for your pharmacy partner. If he or she is sick or incapacitated, YOU need to go in and work for them. He or she will return the favor when YOU need it. You can not rely on the company you work for to provide any kind of coverage. YOU need to step and be there when you're needed.

5. Always leave well-written notes about various issues for your pharmacy partner or call them when they come on shift. Nothing runs smoothly in the pharmacy. There's always an issue or two that needs special consideration every single day. Don't make your pharmacy partner repeat all your hard work simply because he or she didn't know what you've accomplished already. Make sure your partner knows why Mrs. X's medication isn't on the shelf ready for her to pick up if she's expecting it.

6. Always take a prescription through the workflow process as far as it will go. New insurance? Process it for cash and fill it. It can be reprocessed later at the register. No pharmacist wants to start at square one at 6:30 pm when there's a line of people and the technicians have gone home. Don't leave work to do that should have been completed already!

7. If you eat or drink something that belongs to another pharmacist or technician, replace it before you leave. You're thirsty now, they will be thirsty later. Be courteous.

8. Never say anything negative or derogatory about another pharmacist or a technician to a patient or customer, no matter what. We represent each other as a pharmacy. Don't embarrass another person you work with by talking about them negatively to the public.

9. Look for ways to help other pharmacists. If you know of another pharmacist that is weak with the company software, be ready, willing, and able to help them learn. If another pharmacist is not up to speed on any particular medication and you are, share your knowledge.

Wednesday, February 19, 2014

Wow! I'm Famous! Well, not really, but...

I made this pharmacy meme awhile back (a year ago or so?) in silent protest over the fact that Goofmart Pharmacy seems to have plenty of money for remodeling our pharmacies but they're always stingy about technician hours.

So last night I found out it's on the PharmacyWeek Facebook page and has oodles of "Likes." Yay! I feel like many commiserate with my plight.

Here's the LINK to the PharmacyWeek FB page. Thanks PharmacyWeek! This is really cool. How about a job so I can get out of retail?

Tuesday, February 18, 2014

The Pharmacist Oath

Recently I ran across this image that was tweeted by another pharmacist. I apologize but I don't recall who tweeted it or where it was from. But this is an example of the unfortunate disconnect that occurs between patient and pharmacist.

As a pharmacist, I took this oath:

I promise to devote myself to a lifetime of service to others through the profession of pharmacy. In fulfilling this vow:

I will consider the welfare of humanity and relief of suffering my primary concerns.

I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients.

I will respect and protect all personal and health information entrusted to me.

I will accept the lifelong obligation to improve my professional knowledge and competence.

I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct.

I will embrace and advocate changes that improve patient care.

I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists.

I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.

So to the author who proposed that this be our credo: I can speak for all pharmacists to say that no one, no pharmacist, tech, or otherwise wants you to suffer, ever. In most cases, pharmacists will do everything in their power to make sure you get your meds correctly and on time. 

We do have specific legal and moral obligations, however. I will adopt your credo and watch out for you, but at the same time, I ask that you do not ask me to do anything that breaks or even bends the law. And while you may think it is just a job for us, it also represents our quality of life. If we lose our job our quality of life is gone, and for a longer period of time than being out of meds for a day or two.

Monday, February 17, 2014

Here's the Problem with "I am a Customer"

A recent bulletin from one of our managers:

Please read the article below and share with all staff members. Everyone should keep this in mind when we come to work:

Allow me to introduce myself. I am the customer.

I am the person that makes the economic engine turn. I am the reason you take home a paycheck. I am the reason you are able to feed your family, pay your mortgage, go on vacation, buy a car, and contribute to your church or synagogue. Because of me, gigantic corporations and small businesses alike have risen and flourished. Because of my absence, they have faded from existence.

The roads you drive on, the police and fireman that protect your community, the teachers that teach your children all exist because of me. Politicians and postal workers, sanitation workers and soldiers all owe their jobs to me. Without me, no taxes would be paid and any and all societal advances would come to a halt.

The wise come to know, respect, and love me. The foolish disregard my importance and suffer accordingly.

By the way, you’ll notice that I didn’t introduce myself as your customer. That’s because I don’t belong to you. Even if I make a purchase from you, that doesn’t mean that I will do it again in the future. You are always on trial and I am always evaluating, measuring, and testing your product and service.

So pay attention to me. Get to know me. Learn my habits. My likes. My dislikes. My desires. My dreams. My values. Learn my language. Learn to recognize my moods.

Above all, treat me with respect. I will not be ill-treated, and why should I be? There are too many businesses vying for my attention. Every time you turn on the television, open a newspaper, or listen to the radio, you see and hear multitudes of companies competing for my attention. There are too many people who are willing to treat me right in exchange for my business.

And know this, I am not easily fooled. Businesses treat me right or suffer the consequences. Sooner or later I always discover dishonesty, disrespect, or disinterest. Most of the time, I don’t announce my displeasure. I simply take my business elsewhere.

Occasionally, we will have disagreements. I don’t like mistakes but I understand that you sometimes make them. The manner in which you handle my complaint determines any future interaction I have with you. And, in my mind, it also determines the character of your business. I rarely ever give you a second chance to make the same mistake twice.

So, watch for me in your business community. If you’re fortunate enough to see me, do everything in your power to woo me and make me your own, because I hold the key to your financial success. It is no exaggeration to say that when you interact with me, your future hangs in the balance.

Learn me. 
Know me.
I am a customer.

Cute little quip, isn't it? And the manager who sent this out is really proud of himself thinking this "captures" the "essence" of everything there is about customer service. 

1. The first problem with this is that it comes from another era, a typical 1950s narrow-minded paradigm that has no place in 2014 or the economy of today. If you're competing on a level playing field... something like selling vacuums or cars, everything you can do to earn and keep a customer makes sense. In the 1950s and 1960s, we were a prosperous nation. There was plenty of money around. Price didn't drive competition. Service was how you earned and kept your clients. 

BUT, in this economy, CASH is king. What drives our economy right now is PRICE. That's why Walmart and CostCo are growing by leaps and bounds. When's the last time anyone from Walmart ever tried to learn about your hopes and dreams? When's the last time you actually spoke English with anyone working at Walmart? At CostCo (who merged with PRICE club -- both names kinda tip you off what they're all about) there's no sales force. CostCo doesn't even do any advertising.

2. Grocery chain pharmacy is entirely different. Entirely. We run a healthcare business that just happens to be inside a grocery store. The rules are different. We take care of PATIENTS, not customers. The "What can I do to get you to drive this car off the lot today, Mr. Carbuyer?" mentality doesn't apply to healthcare. We're here to oversee the care of patients, and unfortunately that means NOT letting the patient have everything they want, and most of the time that's for THEIR safety. That's just a fact. We don't "woo" patients. We provide healthcare. We are professionals and not side-show carnival barkers. Doing "everything" the customer wants simply isn't possible all of the time, and often we end up protecting the patient from themselves. The customer wants her narcs three days early? Sorry, no can do. 

3. We have limitations. Due to the limited resources of the pharmacy, most specifically, technician hours, we simply don't have a time to "get to know" our patients' likes, dislikes, dreams, values, and moods. We're usually running around like mad just trying to keep up with the script count. Get to know our patients? Ha! We barely get to go to the restroom to pee.

Moreover, our PATIENTS probably would think that silly and/or intrusive into their personal life anyway: 

"Hello, Mrs. Zolofttaker, you sure are in a grumpy mood today. Are you depressed because your husband gets his Viagra filled just prior to going on his business trips?"  

Besides, we have yet another mind-numbing contradiction that might destroy the fabric of space-time. We're supposed to recognize and address our customers (patients) by name, but we also have to sign an acknowledgement every six months that directs us to verify every single patient by name, medication, date of birth, address, etc. How's it going to look when we have a conversation like this:

"Hello Mrs. Smith. How are you today? Here for your thyroid medication?"

"Why yes I am!" patient says, thinking... this is great, Crazy RxMan knows me... I feel so special.

"Mrs. Smith, can you verify your name?"

"Uh....  Mrs. Smith." What's with this guy? He's nuts.

"Thank you Mrs. Smith. What is the medication you're picking up today?"

"Uh... you just asked me if I was here for my thyroid medication." This guy is nuts.

So the ONLY thing we can really compete on with other pharmacies around us is speed. Many people are driven by price (See Price isn't Everything) even if it means spending half the day getting their prescription. Other people could care less if we know their name as long as they're getting their narcs pronto or have the best price. Since we don't always have the best price, our only way to drive more business is with speed. 

Sorry, the 1950s "I am a Customer" mantra sucks. I'm sure it impressed upper management and the guy who distributed it was patted on the back for sending this out. Might I recommend a mild soap to get the brown off your nose? After you get cleaned up, please pass on this letter to Corporate:

Allow me to introduce myself. I am one of your pharmacists.

We are the people that fill the prescriptions for the company, our patients, and your customers. We help you to have your stock dividends and bonuses. We are the major reason people come back to the pharmacy already. 

We work under stressful conditions, the likes of which you have absolutely no understanding or appreciation. If a clerk rings up a bottle of soda wrong, no one dies. If the bakery lady burns a batch of bagels, no one dies. But every day we check and recheck multiple prescriptions without adequate help for people who are always, always in a hurry. We make sure their medication is right every time, because if we screw up, someone can die.

Most of the decisions you make about how our pharmacies are run are made without you having any clue how a pharmacy actually operates. If you actually worked in a pharmacy for just one day, you would do away with most of your insane directives and policies.

You want us to get to know the customer's likes, dislikes, moods, dreams, and values? Ok, then give us adequate staffing so we may do so. We're so busy filling prescriptions and trying to keep up with the workload we hardly have time to get to know anyone.


I am a Pharmacist