Tuesday, September 30, 2014

Pharmacist Revenge!

Ring... ring...

"Thank you for calling Goofmart Pharmacy, where a flu shot saves you 10% on your grocery lot. This is Crazy RxMan, how may I help you be well today?"

"Hello, this Jane. Your computer called me, but I don't know what I have to pick up?"

We get calls like this, every stinking day, about ten of them, from people who get medications all the time. Just come down and get it. WHY do you need to know what's there exactly?

"We have Lisinopril for you, Ambien for your husband, and a ProAir for your son."

Ring... ring... the phone is ringing again. The techs are busy helping people.

"Oh, that's right! I remember now. We don't have any that are $150 this time, do we? We can't afford another $150 co-pay."

Ring... ring...

"No, they're all $15 co-pays. You know, you don't need to call. If you don't pick something up, we return it to stock after ten days. No big deal."

Ring... ring...

"Oh, that's right! You told me that last time too."

She hangs up. A little while later her son comes in to pick up all the medications. I ask him if he wants to play a joke on his mother with me. He agrees. She must irritate him too. I tell him when he gets home to tell her mom that one of the medications was $150 and that the Crazy RxMan pharmacist told him he HAD to get the medication, so he did. He laughs and agrees to do it.

About an hour later...

Ring... ring...

"Crazy! This is Jane! What, why, uh, what's going on? Why is this medication $150?! She's perturbed."

I laugh and tell her we pranked her. I can hear her son laughing in the background.

Pharmacist: 1
Annoying patient: 0


Monday, September 29, 2014

One Doc at a Time

Recently the Crazy RxMan went to see the doctor. It was time once again to see the doctor for a routine matter. It's not like retail pharmacy is killing me or anything. No, it was all routine, I tell you. Routine. The appointment was for 10am.

This is not my usual doctor. The "If you like your doctor you can keep him" didn't seem to apply to me, so this is a new doctor for me. I can't see my old doctor because he's not on my new health plan that I didn't want to change.

9:55am ~ I show up and announce myself to the receptionist. She tells me to take a seat.

10:10am ~ My name is called and I'm led to the examination room.

10:45am ~ Finally the doctor comes in and performs the examination.

"Well, we're going to keep your medications the same."

He fiddles on the computer, using the e-Script system to send off refills to my pharmacy.

"Ok, I sent them off. They'll be ready when you get there."

My eyes squint. My lips curled. The demon inside me is rising within me.

"How could you possibly know that?" I asked. You see, I've kept my mouth shut about my job and where I work because I wanted to see what he would say after submitting my refill prescriptions.

"Well, uh..."

Obviously he's never had this question before.

"I'm a pharmacist," I said, "And I actually work at the pharmacy you just sent those prescriptions to. When you say that to people, they come to the pharmacy expecting their medications to be ready for them. It doesn't work that way. Sometimes the e-Script system is delayed up to an hour from the time you hit <submit> to the time we actually get it on our end. Plus we need time to enter it on our computer, print a label, fill it, and check it. That takes time too. And if we're busy at the pharmacy, that takes even more time."

The doctor was silent. No one has ever explained this to him before. And that's why us pharmacists have such a hard time with this system. It sure looks great on their end, and after making the patient wait almost an hour before they are ever seen, they're either ignorantly or intentionally sending people to the pharmacy with the idea their prescription will be ready for them when they get there.

Well, that's one down, 893,850 to go.

Saturday, September 27, 2014

Why Flu Shots are so Disruptive

It's that time of year. People want a flu shot. People need a flu shot. People think they WILL DIE if they don't get a flu shot RIGHT FRICKIN' NOW. So let's go on down to the pharmacy and get one!

I'm all for vaccinations. I think everyone should get a flu shot. I vaccinate my children. I really do think you're much better off statistically speaking getting the flu shot. I just wish that my retail pharmacy wasn't so completely rabid about it. It's a cash cow for retail pharmacy, or at least it has been in the past few years. Now that everyone and their pet hamster is giving flu shots, we just don't know how the cash cow will do this year.

I even like the idea of pharmacists giving flu shots... under the right circumstances. But when The Authorities at corporate stick up big signs which say "Flu Shots Today" and "Get your flu shot anytime," there's where I have the problem. Call it bad luck, a twist of fate, or voodoo, but I'll be danged if people don't show up for a flu shot at the WORST POSSIBLE TIME.

Here's some examples: 

Time: Monday

Why: It's Monday, the pharmacy day of hell. Everything happens on Monday. New scripts, refill requests, orders not filled over the weekend, a huge inventory order to handle... this all happens on MONDAY.

Time: Right when the pharmacy opens

Why: We have a bunch of crap to get down right when we open the door. Computers need booting with a bunch of passwords, the automatic refill is staring at us with that come hither look, and reports need signatures and filing. First thing in the morning is a nightmare for most pharmacies. Add a flu shot into the mix and chaos ensues.

Time: Lunchtime

Why: People get this great idea in their head ~ "I'll go get my new script filled at my pharmacy during lunch! It will be easy because no one will be there. I'm so smart!" ~ Unfortunately, everyone else has the same idea, including people that think they'll stop by the pharmacy during lunchtime and get a flu shot. It's also when doctors (who actually get a lunch) clear out their refill requests that pile up on our fax machine and e-script queue.

Time: Right after work

Why: See above. EVERYONE is picking up their prescriptions on the way home from work. Sure, I'll just pop in for a quick jab, right? All they have to do is poke me in the arm, right?

Time: Right after the last tech leaves for the day

Why: Now everything is left for the pharmacist to take care of. New scripts, prescription pick ups, the phone ringing, people with questions, end of day reports... all kinds of crap that we take care of at the end of the day, all alone, with no help. 

Time: Just before closing

Why: The pharmacist is tired. We've had enough. We want to go home. The LAST thing we want to see is someone come by 15 minutes before closing and ask, "Got time to do a flu shot?"

But what is it about the flu shot that makes pharmacists cringe? Here's some possibilities:

1. Most people that want a flu shot are first time patients at the pharmacy. That means we have to add them into the system, get their insurance, have them fill out the paper work, run a claim, and print a label. This process takes much more time. The Authorities want you to believe that it is isn't any different than a new prescription drop off. Oh, that's so wrong. You don't ask patients to fill out a consent and release form every time they drop off a new prescription. 

2. And then there's the slow patient that takes FOREVER to fill out the paperwork. We try to streamline it as much as possible. "Sign, date, and answer 1-8." I even highlight the portions in red. Almost every time they don't listen ~ almost every single time.

3. THEN we have to give them all the paperwork, get payment, or have them sign out the "prescription." If someone is at the pick up window (because it took the flu shot patron FOREVER to fill out the form) we have to kindly ask them to move. They never want to move and roll their eyes.

4. THEN we need to get them into the waiting area, try to finish up anything else pressing in the pharmacy (like the person that was waiting with their eyes permanently rolled into the back of their skull), and head to the waiting area to do the flu shot.

5. THEN there's always the questions about the flu shot after we've already given it. Oh they could have asked anywhere along the way, but no, let's save that question until after it is too late.

It doesn't really take that long to do the actual flu shot part. It's the people part that gums the whole thing up. New patients, people who don't have their insurance with them and want to call their spouse to get it, people who get mad if they have to wait a few minutes, people who insist it should be free when we're getting a co-pay on our end, people who can't line up in the correct place, people who yell at us because their insurance wants them to get the flu shot at their doctor's office... it goes on and on. Add to that a corporate attitude of distrust, and we're all just screwed.

What would be the best way to handle it? Let each pharmacy manager decide when is the best time to give flu shots for his/her store and arrange to have all flu shots given during this time. Overlap time of pharmacists, 1pm to 5pm, or whatever works for that particular pharmacy, NOT "anytime."

"Anytime" is just bad.

Friday, September 26, 2014

Thursday, September 25, 2014

Another Reason Mail Order Pharmacy Sucks

Ring ring...

"Thank you for calling Goofmart Pharmacy, home of the painless flu shot. This is Crazy RxMan, how may I help you be well today?"

"I just opened my bottle of Ly-sint-toe-pril. It looks different. Is it different now?" she asked.

"Ok, let me get on the computer. What's your date of birth?"

I get the patient info and pull her profile up on the computer. I scroll down, and down, and down. There isn't any lisinopril on her profile.

"Mrs. Cordoba, I don't see lisinopril on your profile. What is the Rx number?" I ask.

"It is 1001-03394-304930-493941-19343," she replied. I might be exaggerating there. I just remember it was a long number that went on forever.

"Mrs. Cordoba, that's not one of our Rx numbers. Did you get this in the mail?"


"Does it say 'Goofmart Pharmacy' anywhere on the bottle?" I ask, just to make sure our company didn't send it to her.


"How would I know what's in the bottle? Why didn't you call the people who sent you the bottle?" I ask, annoyed. I'm trying to fill 287 prescriptions all at the same time and I sure as heck don't have time for this phone call.


Mrs. Cordoba doesn't know what to say, and for good reason. She's asking ME to identify a medication we didn't fill for her. And she doesn't want to call the pharmacy that did. That's freaking annoying.

"Mrs. Cordoba, bring the bottle by the pharmacy. We'll take a look at the tablets to make sure what's actually in there if we can. No promises, though, ok?"

"Ok," and she hangs up.

So mail order, you masterful wizards, you've sure got a great thing going for you. You take away our pharmacy business but leave the counseling up to us. That's just great, you sleaze lords.


Wednesday, September 24, 2014

What's Wrong Here?

Yep. Count them. Seven. Seven tablets of Cialis 20mg.

"So what's wrong?" you ask.

The problem is the computer says we're supposed to have eight tablets left. And according to the computer log, the last person to dispense Cialis was the floater pharmacist we had here last Friday.

This seems to happen every time we have a floater pharmacist fill in for a day. And what's more, I'm not certain if it was that floater pharmacist, a technician, or my pharmacy partner that made the one tablet disappear.

The only thing I know for sure that it wasn't me.

And when stuff like this happens, everyone is a suspect. And I don't like that.

Damn thieves.

Tuesday, September 23, 2014

Pharmacy Robbery: What do you do?

Recently there have been a bunch of #Pharmacy robberies!

Here's some tips and advice for the pharmacist and technicians:

SAFETY is your number one concern.

To ensure everyone's safety, do this:

1. Give the robber whatever they want!
2. Do NOT try to be a hero. Do NOT try to disarm the robber. Do NOT try to stop him/her.
3. Do NOT make quick motions that could startle the robber. Tell the robber what you are doing as you're doing it as to not cause any confusion. Example: "I am reaching over to get you a bag for your oxycodone."
4. Follow the directions of the robber until they leave.
5. Do NOT chase after the subject(s) committing the robbery. Instead, call 9-1-1. Tell them you were ROBBED (this is different than a burglary). If a weapon was displayed, tell the 9-1-1 operator what you saw immediately. This will speed the police's arrival.

The Authorities you work for may have their own set of "rules" regarding a robbery, such as YOU trying to remember a description of the robber or remembering what they touched (for fingerprints) or making sure you keep the note if a note is passed to you.

Yeah, that's all great, but YOUR CONCERN is YOU and YOUR TECHNICIANS, so screw that ideaRemember, this is the same brain trust that decided to remodel your pharmacy with ultra low counter tops out in the open making it easy for anyone to jump over... so let the videotape be evidence. 

YOUR concern is your safety and the people you work with, not the multi-million dollar company and a few bottles of oxycodone. Don't jeopardize your safety trying to notice all the moles and tattoos of your robber. This will just piss them off. Never, ever piss anyone off who has a gun.

Your company likely will have a policy and procedure to follow AFTER the robbery. Follow that after dialing 9-1-1.

Here's some links to recent news articles on pharmacy robberies:


Monday, September 22, 2014

The Authorities DEMAND Gratittude

The Authorities recently had a meeting for pharmacists in the tri-county area. It was mandatory. You were not paid to be there, but you had to show up. That's Goofmart Pharmacy.

On the agenda of the meeting was a section on "gratitude."

First they reviewed the definition of gratitude. Despite the fact we are all adults, apparently we needed to be reminded what gratitude means like we're all in Kindergarten.

The poor sucker who had to give this portion of the day's presentations listed what he's thankful for in his life. Some of his choices were:

People I work with, Environment, Income, Benefits, Stability, Opportunity

A few quotes on gratitude were presented, such as one by billionaire Oprah Winfrey:

"Be thankful for what you have; you'll end up having more. If you concentrate on what you don't have, you will never, ever have enough."

Oprah Winfrey must be the most thankful person alive then.

My favorite was, "Never let the things you want make you forget the things that you have."

So, if you need 60 tech hours, just be thankful you have have 30 hours and shut up.

Finally, the presenter went over what Goofmart Pharmacy expects of the pharmacists with regard to gratitude. Here's a few:

< We need to support the company that supports us

< We should all be shopping at Goofmart Grocery for a majority of our grocery needs and ALL of our prescription needs

< We should encourage our friends, family, and neighbors to support the company that we work for when they can

As you can very well imagine, I take exception to all of this. We're not children. We're paid to do a job, and what The Authorities are expecting is a totality of loyalty. You know what, that concept isn't that bad, granted it is a two-way street. 

But here's the problem with the George Orwellian double-speak:

= The Authorities have done NOTHING to foster our loyalty in any way. Tech hours are ALWAYS a problem. When we do get increased tech hours, then we're told they don't have anyone to send to us.  

= The grocery's prices are higher than our competitors and we do not get a discount for being an employee. Why would we pay more? Especially when you consider our hourly wage is always increased six months behind our competitor pharmacies.

= Why is it our job to bring in clients? That's your job, corporate. I'll be the pharmacist. You be marketing, ok?

I do enjoy what I do and I'm thankful for what I have. My level of gratitude for the company matches what is is given to me. It's that simple. Telling me that I need to have gratitude for having to deal with "it is what it is" won't fly with me. 

Here's a nice article on workplace gratitude. The Authorities at Goofmart Pharmacy might find this valuable: LINK